Effectiveness and long-term outcome of cardiopulmonary resuscitation in paediatric intensive care units in Spain

Rodrı́guez-Núñez, Antonio; López‐Herce, Jesús; García, Cristina; Carrillo, Ángel; Domı́nguez, Pedro; Calvo, Custodio; Delgado, Miguel

doi:10.1016/j.resuscitation.2005.11.020

Cited by 75 publications

(47 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, by prolonging the ventilation interval further, adverse effects on outcome become apparent. We found that median time to ROSC was significantly longer when ventilating for 90 compared to 30 s. As it has been suggested that the duration of CPR attempts is the best indicator of mortality both in pediatric intensive care patients and in infants requiring CPR at birth [13,14] , a 90 s delay may be too long.…”

Section: Discussionmentioning

confidence: 60%

See 1 more Smart Citation

Delayed Onset of Cardiac Compressions in Cardiopulmonary Resuscitation of Newborn Pigs with Asphyctic Cardiac Arrest

et al. 2010

View full text Add to dashboard Cite

Background: When 30 s of initial positive pressure ventilation fails to stabilize the heart rate (HR) of newborns in the delivery room, the International Liaison Committee on Resuscitation guidelines recommend initiation of cardiac compressions. However, it may take longer than 30 s to establish effective pulmonary gas exchange. Whether a longer period of initial ventilation to reverse asphyxia would result in less need for cardiac compressions is unknown. Objectives: Our purpose was to investigate the effect of three different initial ventilation intervals prior to initiation of cardiac compressions on hemodynamic parameters, arterial blood gases, oxygen saturations and markers of inflammation and hypoxic damage in a piglet model of asystole due to asphyxia. Methods: Noroc piglets were anesthetized and mechanically ventilated. Progressive asphyxia was induced until asystole occurred. Randomization was made to ventilation with 21% O₂ for (1) 30 s (n = 16), (2) 1 min (n = 16), or (3) 1.5 min (n = 8) before initiation of cardiac compressions. Return of spontaneous circulation (ROSC) was defined as HR ≧100 min^–1. Results: Piglets initially ventilated for 30 s and 1 and 1.5 min achieved ROSC in a median of 150 (interquartile range 115–180),163 (124–177) and 282 (199–364) s, respectively. p value for group 1 versus group 2 was 0.51 and <0.001 for group 1 versus group 3. There were no differences in temporal changes in oxygen saturations, mean arterial blood pressure, HR, pH, pCO₂, interleukin-1β or lactate/pyruvate ratios between groups. Conclusion: Although an additional 30 s to ensure effective ventilation does not impair the speed or success in achieving ROSC, delaying circulatory support for as long as 1.5 min of initial ventilation may be harmful.

show abstract

Section: Discussionmentioning

confidence: 60%

“…There is evidence that there is a correlation between the duration of resuscitation and incidence of injury [18] . Recent studies also suggest that a longer duration of CPR, as well as more doses of adrenaline and bicarbonate, are associated with higher mortality [13] .…”

Section: Discussionmentioning

confidence: 99%

Delayed Onset of Cardiac Compressions in Cardiopulmonary Resuscitation of Newborn Pigs with Asphyctic Cardiac Arrest

et al. 2010

View full text Add to dashboard Cite

show abstract

“…It is also reasonable to believe that the length of a resuscitative attempt itself affects outcome, both in the short and long term. It has been suggested that the duration of CPR attempts is the best indicator of mortality both in paediatric intensive care patients and in infants requiring CPR at birth [29,30] .…”

Section: Discussionmentioning

confidence: 99%

Resuscitation of Severely Asphyctic Newborn Pigs with Cardiac Arrest by Using 21% or 100% Oxygen

Solevåg¹,

Dannevig²,

Nakstad

et al. 2010

Neonatology

View full text Add to dashboard Cite

Background: In spite of evidence suggesting that resuscitation with 100% O₂ is detrimental, international guidelines still recommend its use. Clinical studies comparing 21% and 100% O₂ included many infants with only mild and moderate asphyxia. Objectives: We aimed to investigate the effect of these oxygen fractions on haemodynamic parameters, arterial blood gases, oxygen saturation indices and markers of inflammation and hypoxic damage when resuscitating asystolic newborn pigs following asphyxia. Methods: Newborn swine (n = 32, age 12–36 h, weight 2.0–2.7 kg) were progressively asphyxiated until asystole occurred. Cardiopulmonary resuscitation was initiated with ventilation with either 21% (n = 16) or 100% O₂ (n = 16). Return of spontaneous circulation (ROSC) was defined as a heart rate ≧100 min^–1. Results: Mean time of hypoxia, pH, base excess and pCO₂ at asystole were comparable between the groups. All animals except 2 in the 100% group achieved ROSC. One animal in the 21% group suffered bradycardia at baseline and was excluded. For the remaining 15 animals resuscitated with 21% O₂, median time to ROSC (interquartile range) was 150 s (115–180), whereas animals in the 100% group achieved ROSC after 135 s (113–168); p = 0.80. There were no differences in the temporal changes in mean arterial blood pressure, heart rate, pH, pCO₂, interleukin-1β or lactate/pyruvate ratios. However, systemic and regional cerebral oxygen saturations were higher in the animals resuscitated with 100% oxygen. Conclusion: In this animal model of severe perinatal asphyxia, resuscitation with room air seemed to be as safe and effective as the use of 100% oxygen.

show abstract

“…6,7,[11][12][13]15,16,151,[485][486][487][488][489] None of these associations, however, predict outcome. Witnessed collapse, bystander CPR, and a short interval from collapse to arrival of professionals improve the chances of a successful resuscitation.…”

Section: Termination Of Resuscitative Effortsmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

915

304

View full text Add to dashboard Cite

Effectiveness and long-term outcome of cardiopulmonary resuscitation in paediatric intensive care units in Spain

Cited by 75 publications

References 19 publications

Delayed Onset of Cardiac Compressions in Cardiopulmonary Resuscitation of Newborn Pigs with Asphyctic Cardiac Arrest

Delayed Onset of Cardiac Compressions in Cardiopulmonary Resuscitation of Newborn Pigs with Asphyctic Cardiac Arrest

Resuscitation of Severely Asphyctic Newborn Pigs with Cardiac Arrest by Using 21% or 100% Oxygen

Part 14: Pediatric Advanced Life Support

Contact Info

Product

Resources

About