Incidence and prognosis of nosocomial infection after recovering of cardiac arrest in children

Fernández, A.; Solís, Ana; Cañete, Paloma; Castillo, Jimena del; Urbano, Javier; Carrillo, Ángel; López‐Herce, Jesús

doi:10.1016/j.resuscitation.2017.02.002

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Similar to our findings, prior reports that failed to identify CPR duration as a predictor of outcome often had long median durations of CPR (eg, >30 minutes). A recent study found postarrest infection in 56% of children with in-hospital cardiac arrest and return of spontaneous circulation; 82% of infected children had a positive culture [28]. Similar to our findings, respiratory infections were most common, and no association with death was identified.…”

Section: Commentsupporting

confidence: 89%

One-Year Survival and Neurologic Outcomes After Pediatric Open-Chest Cardiopulmonary Resuscitation

Meert

Delius

Slomine

et al. 2019

The Annals of Thoracic Surgery

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Section: Commentsupporting

confidence: 89%

One-Year Survival and Neurologic Outcomes After Pediatric Open-Chest Cardiopulmonary Resuscitation

Meert

Delius

Slomine

et al. 2019

The Annals of Thoracic Surgery

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“…In Germany, ∼84 of every 100,000 persons annually suffer an acute cardiac arrest requiring early cardiopulmonary resuscitation (CPR), activation of the emergency chain, Advanced Cardiovascular Life Support, transportation, and integrated critical care (1). Hospital-acquired infections (HAI), mainly device-associated bloodstream infections, urinary tract infections, and pneumonia, significantly impact the mortality and morbidity of these patients, especially in those with hypoxemic brain injury (2,3). Proper hand hygiene, especially before aseptic procedures, can significantly reduce these infections (4), especially in critical care settings.…”

Section: Introduction Background/rationalementioning

confidence: 99%

Indications for hand and glove disinfection in Advanced Cardiovascular Life Support: A manikin simulation study

et al. 2023

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Background and aimThere are no investigations on hand hygiene during cardiopulmonary resuscitation (CPR), even though these patients are at high risk for healthcare-associated infections. We aimed to evaluate the number of indicated hand hygiene per CPR case in general and the fraction that could be accomplished without delay for other life-saving techniques through standardized observations.Materials and methodsIn 2022, we conducted Advanced Cardiovascular Life Support (ACLS) courses over 4 days, practicing 33 ACLS case vignettes with standard measurements of chest compression fractions and hand hygiene indications. A total of nine healthcare workers (six nurses and three physicians) participated.ResultsA total of 33 training scenarios resulted in 613 indications for hand disinfection. Of these, 150 (24%) occurred before patient contact and 310 (51%) before aseptic activities. In 282 out of 310 (91%) indications, which have the highest impact on patient safety, the medication administrator was responsible; in 28 out of 310 (9%) indications, the airway manager was responsible. Depending on the scenario and assuming 15 s to be sufficient for alcoholic disinfection, 56–100% (mean 84.1%, SD ± 13.1%) of all indications could have been accomplished without delaying patient resuscitation. Percentages were lower for 30-s of exposure time.ConclusionTo the best of our knowledge, this is the first study investigating the feasibility of hand hygiene in a manikin CPR study. Even if the feasibility is overestimated due to the study setup, the fundamental conclusion is that a relevant part of the WHO indications for hand disinfection can be implemented without compromising quality in acute care, thus increasing the overall quality of patient care.

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Effectiveness of Two Targeted Temperature Management Methods After Pediatric Postcardiac Arrest: A Multicenter International Study*

Yunge

Cordero

Martinez

et al. 2019

Pediatric Critical Care Medicine

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Objectives: It is currently recommended that after return of spontaneous circulation following cardiac arrest, fever should be prevented using TTM through a servo-controlled system. This technology is not yet available in many global settings, where manual physical measures without servo-control is the only option. Our aim was to compare feasibility, safety and quality assurance of servo-controlled system versus no servo-controlled system cooling, TTM protocols for cooling, maintenance and rewarming following return of spontaneous circulation after cardiac arrest in children. Design: Prospective, multicenter, nonrandomized, study. Setting: PICUs of 20 hospitals in South America, Spain, and Italy, 2012–2014. Patients: Under 18 years old with a cardiac arrest longer than 2 minutes, in coma and surviving to PICU admission requiring mechanical ventilation were included. Methods: TTM to 32–34°C was performed by prospectively designed protocol across 20 centers, with either servo-controlled system or no servo-controlled system methods, depending on servo-controlled system availability. We analyzed clinical data, cardiac arrest, temperature, mechanical ventilation duration, length of hospitalization, complications, survival, and neurologic outcomes at 6 months. Primary outcome: feasibility, safety and quality assurance of the cooling technique and secondary outcome: survival and Pediatric Cerebral Performance Category at 6 months. Measurements and Main Results: Seventy patients were recruited, 51 of 70 TTM (72.8%) with servo-controlled system. TTM induction, maintenance, and rewarming were feasible in both groups. Servo-controlled system was more effective than no servo-controlled system in maintaining TTM (69 vs 60%; p = 0.004). Servo-controlled system had fewer temperatures above 38.1°C during the 5 days of TTM (0.1% vs 2.9%; p < 0.001). No differences in mortality, complications, length of mechanical ventilation and of stay, or neurologic sequelae were found between the two groups. Conclusions: TTM protocol (for cooling, maintenance and rewarming) following return of spontaneous circulation after cardiac arrest in children was feasible and safe with both servo-controlled system and no servo-controlled system techniques. Achieving, maintaining, and rewarming within protocol targets were more effective with servo-controlled system versus no servo-controlled system techniques.

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Incidence and prognosis of nosocomial infection after recovering of cardiac arrest in children

Cited by 3 publications

References 19 publications

One-Year Survival and Neurologic Outcomes After Pediatric Open-Chest Cardiopulmonary Resuscitation

One-Year Survival and Neurologic Outcomes After Pediatric Open-Chest Cardiopulmonary Resuscitation

Indications for hand and glove disinfection in Advanced Cardiovascular Life Support: A manikin simulation study

Effectiveness of Two Targeted Temperature Management Methods After Pediatric Postcardiac Arrest: A Multicenter International Study*

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