Outcome of 12 drowned children with attempted resuscitation on cardiopulmonary bypass: An analysis of variables based on the “Utstein Style for Drowning”

Eich, Christoph; Bräuer, Anselm; Timmermann, Arnd; Schwarz, Stephan; Russo, Sebastian G.; Neubert, Karin; Graf, Bernhard M.; Aleksić, Ivan

doi:10.1016/j.resuscitation.2007.03.013

Cited by 80 publications

(100 citation statements)

References 33 publications

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“…The majority of pediatric arrests are asphyxial in origin, resulting from airway obstruction or failure of ventilation, with the most common pathophysiologic pathway being the progression from bradycardia with hypoperfusion to PEA and/or asystole. 2,[30][31][32] In this study, however, initial PEA rhythms were converted to VF rather than asystole during the cardiac arrest interval. This is in accordance with recent studies that show the incidence of VF as an initial outcome of out-of-hospital cardiac arrest rhythm appears to be increasing, 1,11,[33][34][35][36][37] especially in children 9 to 17 years of age.…”

Section: Discussionmentioning

confidence: 75%

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Varvarousi

Chalkias

Stefaniotou

et al. 2015

Academic Emergency Medicine

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Objectives:The objective was to analyze the cardiac arrest rhythms presenting during asphyxial cardiac arrest (ACA).Methods: Asphyxial cardiac arrest was induced in 30 Landrace large white piglets, aged 12 to 15 weeks and with a mean (AESD) weight of 20 (AE2) kg. After the onset of cardiac arrest, the animals were left untreated for 4 minutes, after which cardiopulmonary resuscitation was commenced. Heart rhythms were monitored from the onset of asphyxia until return of spontaneous circulation or death.

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Section: Discussionmentioning

confidence: 75%

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Varvarousi

Chalkias

Stefaniotou

et al. 2015

Academic Emergency Medicine

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“…Although more drowning patients receive bystander CPR, lay rescuers should still make every effort to minimize resuscitation delays, which have been associated with worse outcomes. 7,15,[23][24][25][26] Lay rescuers should follow the 2010 American Heart Association guidelines for CPR and emergency cardiovascular care focusing on early, good-quality chest compressions and rescue breaths for drowning patients. 27 The majority of all drowning cases were unwitnessed, which suggests that a primary mechanism for drowning may be a lack of supervision.…”

Section: Discussionmentioning

confidence: 99%

Drowning: an overlooked cause of out-of-hospital cardiac arrest in Canada

Buick

Lin

Rac

et al. 2014

CJEM

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Introduction: Drowning is a major public health concern, yet little is known about the characteristics of drowning patients. The objectives of this study were to describe the demographic and clinical characteristics of out-of-hospital cardiac arrest (OHCA) attributed to drowning in Ontario and to compare the characteristics of OHCA attributed to drowning to those of presumed cardiac etiology. Methods: A retrospective, observational study was carried out of consecutive OHCA patients of drowning etiology in Ontario between August 2006 and July 2011. Bivariate analysis was used to evaluate differences between drowning and presumed cardiac etiologies. Results: A total of 31,763 OHCA patients were identified, and 132 (0.42%) were attributed to drowning. Emergency medical services treated 98 patients, whereas the remaining 34 met the criteria for legislative death. Overall, 5.1% of drowning patients survived to hospital discharge. When compared to patients of presumed cardiac etiology, drowning patients were younger and their arrest was more likely to be unwitnessed, present with a nonshockable initial rhythm, occur in a public location, and receive bystander cardiopulmonary resuscitation (CPR). A nonsignificant trend was noted for drowning cases to more frequently have a public access AED applied. There were no significant differences in the gender ratio or paramedic response times. Drowning patients were more likely to be transported to hospital but had a trend to be less likely to arrive with a return of spontaneous circulation. They were also more likely to be admitted to hospital but had no difference in survival to hospital discharge. Conclusions: Significant differences exist between OHCA of drowning and presumed cardiac etiologies. Most drownings are unwitnessed, occur in public locations, and present with nonshockable initial rhythms, suggesting that treatment should focus on bystander CPR. Future initiatives should focus on strategies to improve supervision in targeted locations and greater emphasis on bystander-initiated CPR, both of which may reduce drowning mortality.

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“…The biological plausibility that a child could survive submerged for 30 minutes in 6⁰C water as in the case series reported by Eich et al 10 yet not in water a degree or two higher is questionable. The fact that the review only identified 3 cases in water temperatures above 6⁰C implies the evidence upon which this cut off is based is small.…”

Section: -6mentioning

confidence: 92%

Rescue and resuscitation or body retrieval—The dilemmas of search and rescue efforts in drowning incidents

Perkins

2011

Resuscitation

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Outcome of 12 drowned children with attempted resuscitation on cardiopulmonary bypass: An analysis of variables based on the “Utstein Style for Drowning”

Cited by 80 publications

References 33 publications

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Intraarrest Rhythms and Rhythm Conversion in Asphyxial Cardiac Arrest

Drowning: an overlooked cause of out-of-hospital cardiac arrest in Canada

Rescue and resuscitation or body retrieval—The dilemmas of search and rescue efforts in drowning incidents

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