Subsequent Shockable Rhythm During Out-of-Hospital Cardiac Arrest in Children With Initial Non-Shockable Rhythms: A Nationwide Population-Based Observational Study

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2016 Oct 30

PMID 27792647

Citations 3

Authors

Yoshikazu Goto

Akira Funada

Yumiko Goto

Affiliations

Soon will be listed here.

Abstract

Background: The effect of a subsequent treated shockable rhythm during cardiopulmonary resuscitation on the outcome of children who suffer out-of-hospital cardiac arrest with initial nonshockable rhythm is unclear. We hypothesized that subsequent treated shockable rhythm in children with out-of-hospital cardiac arrest would improve survival with favorable neurological outcomes (Cerebral Performance Category scale 1-2).

Methods And Results: From the All-Japan Utstein Registry, we analyzed the records of 12 402 children (aged <18 years) with out-of-hospital cardiac arrest and initial nonshockable rhythms. Patients were divided into 2 cohorts: subsequent treated shockable rhythm (YES; n=239) and subsequent treated shockable rhythm (NO; n=12 163). The rate of 1-month cerebral performance category 1 to 2 in the subsequent treated shockable rhythm (YES) cohort was significantly higher when compared to the subsequent treated shockable rhythm (NO) cohort (4.6% [11 of 239] vs 1.3% [155 of 12 163]; adjusted odds ratio, 2.90; 95% CI, 1.42-5.36; all P<0.001). In the subsequent treated shockable rhythm (YES) cohort, the rate of 1-month cerebral performance category 1 to 2 decreased significantly as time to shock delivery increased (17.7% [3 of 17] for patients with shock-delivery time 0-9 minutes, 7.3% [8 of 109] for 10-19 minutes, and 0% [0 of 109] for 20-59 minutes; P<0.001 [for trend]). Age-stratified outcomes showed no significant differences between the 2 cohorts in the group aged <7 years old: 1.3% versus 1.4%, P=0.62.

Conclusions: In children with out-of-hospital cardiac arrest and initial nonshockable rhythms, subsequent treated shockable rhythm was associated with improved 1-month survival with favorable neurological outcomes. In the cohort of older children (7-17 years), these outcomes worsened as time to shock delivery increased.

Citing Articles

Association of subsequent treated shockable rhythm with outcomes after paediatric out-of-hospital cardiac arrests: A nationwide, population-based observational study.

Goto Y, Funada A, Maeda T, Goto Y Resusc Plus. 2021; 8:100181.

PMID: 34816142 PMC: 8592867. DOI: 10.1016/j.resplu.2021.100181.

[Paediatric Life Support].

Van de Voorde P, Turner N, Djakow J, de Lucas N, Martinez-Mejias A, Biarent D Notf Rett Med. 2021; 24(4):650-719.

PMID: 34093080 PMC: 8170638. DOI: 10.1007/s10049-021-00887-9.

Out-of-hospital cardiac arrest prognosis during the COVID-19 pandemic.

Pranata R, Lim M, Yonas E, Siswanto B, Meyer M Intern Emerg Med. 2020; 15(5):875-877.

PMID: 32647947 PMC: 7345450. DOI: 10.1007/s11739-020-02428-7.

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