. 2020 Aug:153:209-216.

doi: 10.1016/j.resuscitation.2020.06.027. Epub 2020 Jul 1.

Association between time of day and CPR quality as measured by CPR hemodynamics during pediatric in-hospital CPR

Heather A Wolfe¹, Ryan W Morgan², Robert M Sutton², Ron W Reeder³, Kathleen L Meert⁴, Murray M Pollack⁵, Andrew R Yates⁶, John T Berger⁷, Christopher J Newth⁸, Joseph A Carcillo⁹, Patrick S McQuillen¹⁰, Rick E Harrison¹¹, Frank W Moler¹², Todd C Carpenter¹³, Daniel A Notterman¹⁴, J Michael Dean³, Vinay M Nadkarni², Robert A Berg²; Eunice Kennedy Shriver National Institute of Child Health Human Development Collaborative Pediatric Critical Care Research Network Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation (PICqCPR) investigators

Collaborators, Affiliations

Collaborators

Eunice Kennedy Shriver National Institute of Child Health Human Development Collaborative Pediatric Critical Care Research Network Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation (PICqCPR) investigators:
Athena F Zuppa, Katherine Graham, Carolann Twelves, Mary Ann Diliberto, Richard Holubkov, Russell Telford, Christopher Locandro, Whitney Coleman, Alecia Peterson, Julie Thelen, Sabrina Heidemann, Ann Pawluszka, Elyse Tomanio, Michael J Bell, Mark W Hall, Lisa Steele, Jeni Kwok, Anil Sapru, Alan Abraham, Mustafa F Alkhouli, Thomas P Shanley, Monica Weber, Heidi J Dalton, Aimee La Bell, Peter M Mourani, Kathryn Malone, Allan Doctor

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: wolfeh@email.chop.edu.
² Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States.
³ Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States.
⁴ Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, MI, United States.
⁵ Department of Pediatrics, Children's National Medical Center, Washington D.C., United States; Department of Pediatrics, Phoenix Children's Hospital, Phoenix, AZ, United States.
⁶ Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, United States.
⁷ Department of Pediatrics, Children's National Medical Center, Washington D.C., United States.
⁸ Department of Anesthesiology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, United States.
⁹ Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, United States.
¹⁰ Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, United States.
¹¹ Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, United States.
¹² Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, MI, United States.
¹³ Department of Pediatrics, Denver Children's Hospital, University of Colorado, Denver, CO, United States.
¹⁴ Department of Molecular Biology, Princeton University, Princeton, New Jersey, United States.

PMID: 32622016
PMCID: PMC7431912
DOI: 10.1016/j.resuscitation.2020.06.027

Association between time of day and CPR quality as measured by CPR hemodynamics during pediatric in-hospital CPR

Heather A Wolfe et al. Resuscitation. 2020 Aug.

. 2020 Aug:153:209-216.

doi: 10.1016/j.resuscitation.2020.06.027. Epub 2020 Jul 1.

Authors

Collaborators

Eunice Kennedy Shriver National Institute of Child Health Human Development Collaborative Pediatric Critical Care Research Network Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation (PICqCPR) investigators:
Athena F Zuppa, Katherine Graham, Carolann Twelves, Mary Ann Diliberto, Richard Holubkov, Russell Telford, Christopher Locandro, Whitney Coleman, Alecia Peterson, Julie Thelen, Sabrina Heidemann, Ann Pawluszka, Elyse Tomanio, Michael J Bell, Mark W Hall, Lisa Steele, Jeni Kwok, Anil Sapru, Alan Abraham, Mustafa F Alkhouli, Thomas P Shanley, Monica Weber, Heidi J Dalton, Aimee La Bell, Peter M Mourani, Kathryn Malone, Allan Doctor

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States. Electronic address: wolfeh@email.chop.edu.
² Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States.
³ Department of Pediatrics, University of Utah, Salt Lake City, Utah, United States.
⁴ Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, MI, United States.
⁵ Department of Pediatrics, Children's National Medical Center, Washington D.C., United States; Department of Pediatrics, Phoenix Children's Hospital, Phoenix, AZ, United States.
⁶ Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, United States.
⁷ Department of Pediatrics, Children's National Medical Center, Washington D.C., United States.
⁸ Department of Anesthesiology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, United States.
⁹ Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, United States.
¹⁰ Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, United States.
¹¹ Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, United States.
¹² Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, MI, United States.
¹³ Department of Pediatrics, Denver Children's Hospital, University of Colorado, Denver, CO, United States.
¹⁴ Department of Molecular Biology, Princeton University, Princeton, New Jersey, United States.

PMID: 32622016
PMCID: PMC7431912
DOI: 10.1016/j.resuscitation.2020.06.027

Abstract

Introduction: Patients who suffer in-hospital cardiac arrest (IHCA) are less likely to survive if the arrest occurs during nighttime versus daytime. Diastolic blood pressure (DBP) as a measure of chest compression quality was associated with survival from pediatric IHCA. We hypothesized that DBP during CPR for IHCA is lower during nighttime versus daytime.

Methods: This is a secondary analysis of data collected from the Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation Study. Pediatric or Pediatric Cardiac Intensive Care Unit patients who received chest compressions for ≥1 min and who had invasive arterial BP monitoring were enrolled. Nighttime was defined as 11:00PM to 6:59AM and daytime as 7:00AM until 10:59PM. Primary outcome was attainment of DBP ≥ 25 mmHg in infants <1 year and ≥30 mmHg in older children. Secondary outcomes were mean DBP, ROSC, and survival to hospital discharge. Univariable and multivariate analyses evaluated the relationships between time (nighttime vs. daytime) and outcomes.

Results: Between July 1, 2013 and June 30, 2016, 164 arrests met all inclusion/exclusion criteria: 45(27%) occurred at nighttime and 119(73%) during daytime. Average DBPs achieved were not different between groups (DBP: nighttime 28.3 mmHg[25.3, 36.5] vs. daytime 29.6 mmHg[21.8, 38.0], p = 0.64). Relative risk of DBP threshold met during nighttime vs. daytime was 1.27, 95%CI [0.80, 1.98], p = 0.30. There was no significant nighttime vs. daytime difference in ROSC (28/45[62%] vs. 84/119[71%] p = 0.35) or survival to hospital discharge (16/45[36%] vs. 61/119[51%], p = 0.08).

Conclusions: In this cohort of pediatric ICU patients with IHCA, there was no significant difference in DBP during CPR between nighttime and daytime.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation (CPR); In-Hospital; Outcomes; Pediatric; Survival.

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Association between time of day and CPR quality as measured by CPR hemodynamics during pediatric in-hospital CPR

Collaborators

Affiliations

Association between time of day and CPR quality as measured by CPR hemodynamics during pediatric in-hospital CPR

Authors

Collaborators

Affiliations

Abstract

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Cited by

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