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Early Cardiac Arrest Hemodynamics, End-Tidal C o2 , and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021).
Yates, Andrew R; Naim, Maryam Y; Reeder, Ron W; Ahmed, Tageldin; Banks, Russell K; Bell, Michael J; Berg, Robert A; Bishop, Robert; Bochkoris, Matthew; Burns, Candice; Carcillo, Joseph A; Carpenter, Todd C; Dean, J Michael; Diddle, J Wesley; Federman, Myke; Fernandez, Richard; Fink, Ericka L; Franzon, Deborah; Frazier, Aisha H; Friess, Stuart H; Graham, Kathryn; Hall, Mark; Hehir, David A; Horvat, Christopher M; Huard, Leanna L; Maa, Tensing; Manga, Arushi; McQuillen, Patrick S; Morgan, Ryan W; Mourani, Peter M; Nadkarni, Vinay M; Notterman, Daniel; Pollack, Murray M; Sapru, Anil; Schneiter, Carleen; Sharron, Matthew P; Srivastava, Neeraj; Tilford, Bradley; Viteri, Shirley; Wessel, David; Wolfe, Heather A; Yeh, Justin; Zuppa, Athena F; Sutton, Robert M; Meert, Kathleen L.
Affiliation
  • Yates AR; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
  • Naim MY; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Reeder RW; Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Ahmed T; Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI.
  • Banks RK; Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Bell MJ; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Berg RA; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Bishop R; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
  • Bochkoris M; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Burns C; Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI.
  • Carcillo JA; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Carpenter TC; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
  • Dean JM; Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Diddle JW; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Federman M; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA.
  • Fernandez R; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
  • Fink EL; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Franzon D; Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA.
  • Frazier AH; Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.
  • Friess SH; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Graham K; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.
  • Hall M; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Hehir DA; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
  • Horvat CM; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Huard LL; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Maa T; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA.
  • Manga A; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
  • McQuillen PS; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.
  • Morgan RW; Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA.
  • Mourani PM; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Nadkarni VM; Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's research Institute, Little Rock, AR.
  • Notterman D; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Pollack MM; Department of Molecular Biology, Princeton University, Princeton, NJ.
  • Sapru A; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Schneiter C; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA.
  • Sharron MP; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
  • Srivastava N; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Tilford B; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA.
  • Viteri S; Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI.
  • Wessel D; Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children and Thomas Jefferson University, Wilmington, DE.
  • Wolfe HA; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Yeh J; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Zuppa AF; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Sutton RM; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Meert KL; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
Pediatr Crit Care Med ; 25(4): 312-322, 2024 Apr 01.
Article in En | MEDLINE | ID: mdl-38088765
ABSTRACT

OBJECTIVES:

Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal C o2 (ET co2 ) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients.

DESIGN:

Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497).

SETTING:

Eighteen ICUs participated in ICU-RESUS. PATIENTS There were 97 ECPR patients with hemodynamic waveforms during cardiopulmonary resuscitation.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

Overall, 71 of 97 patients (73%) were younger than 1 year old, 82 of 97 (85%) had congenital heart disease, and 62 of 97 (64%) were postoperative cardiac surgical patients. Forty of 97 patients (41%) survived with favorable neurologic outcome. We failed to find differences in diastolic or systolic blood pressure, proportion achieving age-based target diastolic or systolic blood pressure, or chest compression rate during the initial 10 minutes of CPR between patients who survived with favorable neurologic outcome and those who did not. Thirty-five patients had ET co2 data; of 17 survivors with favorable neurologic outcome, four of 17 (24%) had an average ET co2 less than 10 mm Hg and two (12%) had a maximum ET co2 less than 10 mm Hg during the initial 10 minutes of resuscitation.

CONCLUSIONS:

We did not identify an association between early hemodynamics achieved by high-quality CPR and survival to hospital discharge with favorable neurologic outcome after pediatric ECPR. Candidates for ECPR with ET co2 less than 10 mm Hg may survive with favorable neurologic outcome.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Heart Arrest Limits: Child / Humans / Infant Language: En Journal: Pediatr Crit Care Med Journal subject: PEDIATRIA / TERAPIA INTENSIVA Year: 2024 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Heart Arrest Limits: Child / Humans / Infant Language: En Journal: Pediatr Crit Care Med Journal subject: PEDIATRIA / TERAPIA INTENSIVA Year: 2024 Document type: Article