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Sodium Bicarbonate Use During Pediatric Cardiopulmonary Resuscitation: A Secondary Analysis of the ICU-RESUScitation Project Trial.
Cashen, Katherine; Reeder, Ron W; Ahmed, Tageldin; Bell, Michael J; Berg, Robert A; Burns, Candice; Carcillo, Joseph A; Carpenter, Todd C; Dean, J Michael; Diddle, J Wesley; Federman, Myke; Fink, Ericka L; 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; Naim, Maryam Y; Notterman, Daniel; Palmer, Chella A; Pollack, Murray M; Schneiter, Carleen; Sharron, Matthew P; Srivastava, Neeraj; Wessel, David; Wolfe, Heather A; Yates, Andrew R; Zuppa, Athena F; Sutton, Robert M; Meert, Kathleen L.
  • Cashen K; Department of Pediatrics, Duke Children's Hospital, Duke University, Durham, NC.
  • 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.
  • 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.
  • 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.
  • Fink EL; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA.
  • Frazier AH; Department of Pediatrics, 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 Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
  • Naim MY; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Notterman D; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Palmer CA; Department of Molecular Biology, Princeton University, Princeton, NJ.
  • Pollack MM; Department of Pediatrics, University of Utah, Salt Lake City, UT.
  • Schneiter C; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • 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.
  • Wessel D; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA.
  • Wolfe HA; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC.
  • Yates AR; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
  • Zuppa AF; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
  • 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 ; 23(10): 784-792, 2022 10 01.
Article en En | MEDLINE | ID: mdl-35880872
ABSTRACT

OBJECTIVES:

To evaluate associations between sodium bicarbonate use and outcomes during pediatric in-hospital cardiac arrest (p-IHCA).

DESIGN:

Prespecified secondary analysis of a prospective, multicenter cluster randomized interventional trial.

SETTING:

Eighteen participating ICUs of the ICU-RESUScitation Project (NCT02837497). PATIENTS Children less than or equal to 18 years old and greater than or equal to 37 weeks post conceptual age who received chest compressions of any duration from October 2016 to March 2021.

INTERVENTIONS:

None. MEASUREMENTS AND MAIN

RESULTS:

Child and event characteristics, prearrest laboratory values (2-6 hr prior to p-IHCA), pre- and intraarrest hemodynamics, and outcomes were collected. In a propensity score weighted cohort, the relationships between sodium bicarbonate use and outcomes were assessed. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge with favorable neurologic outcome. Of 1,100 index cardiopulmonary resuscitation events, median age was 0.63 years (interquartile range, 0.19-3.81 yr); 528 (48.0%) received sodium bicarbonate; 773 (70.3%) achieved ROSC; 642 (58.4%) survived to hospital discharge; and 596 (54.2%) survived to hospital discharge with favorable neurologic outcome. Among the weighted cohort, sodium bicarbonate use was associated with lower survival to hospital discharge rate (adjusted odds ratio [aOR], 0.7; 95% CI, 0.54-0.92; p = 0.01) and lower survival to hospital discharge with favorable neurologic outcome rate (aOR, 0.69; 95% CI, 0.53-0.91; p = 0.007). Sodium bicarbonate use was not associated with ROSC (aOR, 0.91; 95% CI, 0.62-1.34; p = 0.621).

CONCLUSIONS:

In this propensity weighted multicenter cohort study of p-IHCA, sodium bicarbonate use was common and associated with lower rates of survival to hospital discharge.
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Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Reanimación Cardiopulmonar / Paro Cardíaco Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans / Infant Idioma: En Año: 2022 Tipo del documento: Article
Texto completo
Imprimir
XML
PubMed Links
Search on Google

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Reanimación Cardiopulmonar / Paro Cardíaco Tipo de estudio: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Límite: Child / Humans / Infant Idioma: En Año: 2022 Tipo del documento: Article