Mechanical CPR in a child: can one size fit all?

Sugarman, Leah; Hedley, David; Crowe, Steve

doi:10.1136/bcr-2017-219728

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…There is a case report of the same device used in an 11-year-old child with the addition of a blanket under the patient’s back to raise the patient and allow for LUCAS to provide effective compressions. 17 Our patient appears to have received good-quality sternal compressions and therefore cardiac output with the LUCAS mechanical compression device given the prolonged duration of CPR and good eventual neurologic outcome. This has been noted in previous reports and animal studies suggesting that the trapezoidal waveform created by the mechanical devices provides superior coronary and cerebral perfusion compared to the sinusoidal waveform generated by manual compressions.…”

Section: Discussionmentioning

confidence: 72%

Prolonged cardiopulmonary resuscitation and low flow state are not contraindications for extracorporeal support

et al. 2019

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Outcomes of out-of-hospital cardiac arrest are poor irrespective of the patient age group and circumstances. Survival to discharge after out-of-hospital arrest in children is less than 10%. Use of extracorporeal cardiopulmonary resuscitation is increasing and has been shown to improve outcomes in some situations. However, the candidacy for such augmentation is based on patient selection, institutional practices, and availability of an extracorporeal membrane oxygenation center. Often, duration of resuscitation, low flow state, presenting pH, and circumstances of arrest dictate candidacy for extracorporeal membrane oxygenation. We present a case of extremely prolonged resuscitation for out-of-hospital arrest in a pediatric patient, and we describe the use of mechanical compression device and transition to extracorporeal membrane oxygenation. We present the case outcome as well as brief discussion about controversies in extracorporeal cardiopulmonary resuscitation. We hope the case provides an opportunity for further discussion regarding opportunities to improve selection, use of extracorporeal cardiopulmonary resuscitation, and impact outcomes.

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Section: Discussionmentioning

confidence: 72%

Prolonged cardiopulmonary resuscitation and low flow state are not contraindications for extracorporeal support

et al. 2019

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“…The question remains whether it is possible to perform automatic compression in pediatric patients. Individual cases are described in the literature (24). Animal model studies have also been conducted, which have not shown any difference (25).…”

Section: Discussionmentioning

confidence: 99%

Impact of automatic chest compression devices in out-of-hospital cardiac arrest

et al. 2020

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Background: High quality chest compressions (CCs) are of crucial importance during cardio-pulmonary resuscitation (CPR). Currently, there are no clear evidences that the use of automatic chest compression devices (ACCD) are superior to manual CCs during out-of-hospital CPR. This study aimed to estimate if availability of ACCDs for two-man rescue teams had any impact on CPR efficiency and a rate of successful transport of patients after out-of-hospital cardiac arrest (OHCA) to emergency departments. Methods: The study was designed as a retrospective cohort study. The research tool was the analysis of medical charts of Emergency Medical Service (EMS) in one million agglomeration in Poland in 2018.ACCDs were available for two-man paramedical teams in a half of ambulances and this fact was criterion of group division [ACCD (n=181) and manual CC (MCC) (n=303)]. The following variables such as gender (male/female), age, area of intervention (town/countryside), return of spontaneous circulation (ROSC) followed by successful transport to hospital were compared between subgroups. Results: Among 71,282 interventions in 2018, there were 484 resuscitations undertaken with complete medical data. ROSC and transport to hospital was achieved in 54.9% of individuals, statistically more often among ACCD subjects (63.5%) than those compressed manually (49.8%) (P=0.003). Moreover, the use of ACCD was associated with higher chances of ROSC in younger patients (P=0.027) and if cardiac arrest had place in the town centre (P=0.002). Conclusions: Our observation revealed that the use of ACCD in the pre-hospital emergency care involving two-man rescue teams may increase the prevalence of ROSC among OHCA patients.

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“…33 A case report on an 11-year patient reported its use, but it is recommended only in extreme circumstances. 34 This patient did not have adequate flat space on the back to fix the device, and the anatomical configuration of the spine did not allow correct usage of the device. In addition, an option for home or long-term care facility use was also being sought and the LUCAS device was too costly to dedicate to a long-term care or home solution.…”

Section: Mechanical Cpr Devicesmentioning

confidence: 95%

“…Mechanical CPR devices such as the LUCAS 2 Chest Compression System (Jolife AB, Lund, Sweden), which was available in the health system where the patient was admitted, were ruled out because it is contraindicated in children or small people where the distance between the pressure pad and the patient's sternum exceeded 15 mm 33 . A case report on an 11-year patient reported its use, but it is recommended only in extreme circumstances 34 . This patient did not have adequate flat space on the back to fix the device, and the anatomical configuration of the spine did not allow correct usage of the device.…”

Section: Case Historymentioning

confidence: 99%