Objectives: 

To develop a consensus framework that can guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU.

Design: 

A three-round electronic Delphi consensus study with an additional in-person session with pediatric resuscitation experts. The modified electronic Delphi consisted of survey questions sent to the expert panel with the goals of (1) achieving consensus on definitions of avoidable, potentially avoidable, and unavoidable PICU in-hospital cardiac arrest and (2) achieving consensus and ranking of a list of factors that contribute to potentially avoidable PICU in-hospital cardiac arrest.

Setting: 

Electronic surveys of resuscitation experts including pediatric critical care, cardiac critical care, emergency medicine, and hospital medicine physicians, nurses, advance practice nurses, and resuscitation researchers.

Patients: 

Not applicable.

Interventions: 

Not applicable.

Measurements and Main Results: 

Over three rounds of an electronic Delphi, 24 resuscitation experts participated. In Round 1, consensus was reached for the definitions of potentially avoidable and unavoidable cardiac arrest. Consensus was not reached for avoidable cardiac arrest. In Round 2, the expert panel agreed with seven factors from the literature and achieved consensus on an additional seven factors. Consensus was achieved on the modified definition of avoidable cardiac arrest. In Round 3, participants were asked to rank the contributing factors in order of their importance. For the in-person session, the consensus definitions and contributing factors from the modified electronic Delphi were presented to a multidisciplinary group of pediatric resuscitation experts and reached consensus for all three definitions.

Conclusions: 

A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. Future work will focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.

中文翻译：

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建立并正式制定可避免复苏复查（SAFECARR）电子Delphi的专家标准：在PICU中分类和复查心脏骤停的共识框架的发展

目标： 

建立共识框架，以指导PICU中小儿院内心脏骤停的分类和评估过程。

设计： 

为期三轮的Delphi电子共识研究，并与儿童复苏专家进行了面对面的交流。修改后的电子Delphi包含发送给专家小组的调查问题，目标是（1）就可避免的，可能避免的和不可避免的PICU院内心脏骤停的定义达成共识，以及（2）达成共识并确定清单导致可能避免的PICU住院心脏骤停的因素。

设置： 

复苏专家的电子调查，包括儿科重症监护，心脏重症监护，急诊医学和医院医学医师，护士，高级执业护士和复苏研究人员。

耐心： 

不适用。

干预措施： 

不适用。

测量和主要结果： 

在3轮电子德尔菲试验中，有24名复苏专家参加了比赛。在第1轮中，就潜在可避免和不可避免的心脏骤停的定义达成共识。对于可避免的心脏骤停未达成共识。在第二轮中，专家小组同意了文献中的七个因素，并就其他七个因素达成了共识。对可避免的心脏骤停的修改定义达成了共识。在第3轮中，要求参与者按其重要性排序影响因素。在面对面的会议上，来自修改过的电子德尔菲的共识定义和影响因素已提交给多学科的儿科复苏专家小组，并就这三个定义达成共识。

结论： 

多学科的儿科复苏专家小组建立了一个基于共识的框架，以对PICU中的儿科医院内心脏骤停进行分类和审查。未来的工作将集中在该框架的应用以及对这些定义的进一步验证以及PICU内外的院内心脏骤停的影响因素。