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Dispatcher-assisted conventional cardiopulmonary resuscitation and outcomes for paediatric out-of-hospital cardiac arrests
Resuscitation ( IF 6.5 ) Pub Date : 2021-10-11 , DOI: 10.1016/j.resuscitation.2021.10.003
Yoshikazu Goto 1 , Akira Funada 2 , Tetsuo Maeda 1 , Yumiko Goto 3
Affiliation  

Aim

As asphyxial cardiac arrest is more common than cardiac arrest from a primary cardiac event in paediatric cardiac arrest, effective ventilation is important during paediatric cardiopulmonary resuscitation (CPR). We aimed to determine optimal dispatcher-assisted CPR instructions for bystanders after paediatric out-of-hospital cardiac arrest (OHCA).

Methods

We analysed the records of 8172 children who received bystander dispatcher-assisted CPR. Data were obtained from an All-Japan Utstein-style registry from 2005 to 2017. Patients were divided into conventional CPR and compression-only CPR groups. The primary study endpoint was 1-month neurologically intact survival, defined as a Cerebral Performance Category score of 1 or 2 (CPC 1–2).

Results

The 1-month CPC 1–2 rate was significantly higher in the dispatcher-assisted conventional CPR group than in the dispatcher-assisted compression-only CPR group (before propensity score matching, 5.7% [175/3077] vs. 3.1% [160/5095], p<0.0001, adjusted odds ratio 2.48, 95% confidence interval 1.19–3.22; after propensity score matching, 6.0% [156/2618] vs. 2.6% [69/2618], p<0.0001, adjusted odds ratio 2.42, 95% confidence interval 1.76–3.32). In most subgroup analyses after matching, dispatcher-assisted conventional CPR had a higher CPC 1–2 rate than dispatcher-assisted compression-only CPR; however, CPC 1–2 rates were similar between the two groups for patients with an initial shockable rhythm, those with total prehospital CPR time ≥20 min, those receiving public access defibrillation, advanced airway management, or adrenaline administration.

Conclusion

Within the limitations of this retrospective observational study, dispatcher-assisted conventional CPR was preferable to dispatcher-assisted compression-only CPR as optimal CPR instructions for coaching callers to perform bystander CPR.



中文翻译:

调度员辅助的常规心肺复苏和儿童院外心脏骤停的结果

目的

在儿科心脏骤停中,窒息性心脏骤停比原发性心脏事件引起的心脏骤停更常见,因此在儿科心肺复苏 (CPR) 期间有效通气非常重要。我们旨在为小儿院外心脏骤停 (OHCA) 后的旁观者确定最佳调度员辅助心肺复苏术指导。

方法

我们分析了接受旁观者调度员辅助心肺复苏术的 8172 名儿童的记录。数据来自 2005 年至 2017 年的全日本 Utstein 式登记处。患者分为常规 CPR 组和仅按压 CPR 组。主要研究终点是 1 个月的神经系统完整生存期,定义为 1 或 2 的脑性能类别评分 (CPC 1-2)。

结果

调度员辅助常规 CPR 组的 1 个月 CPC 1-2 率显着高于调度员辅助单纯按压 CPR 组(倾向评分匹配前,5.7% [175/3077] vs. 3.1% [160 /5095],p <0.0001,调整优势比 2.48,95% 置信区间 1.19–3.22;倾向得分匹配后,6.0% [156/2618] vs. 2.6% [69/2618],p<0.0001,调整优势比 2.42,95% 置信区间 1.76-3.32)。在匹配后的大多数亚组分析中,调度员辅助的常规 CPR 的 CPC 1-2 率高于调度员辅助的单纯按压 CPR;然而,对于具有初始可电击心律的患者、院前 CPR 总时间≥20 分钟的患者、接受公共通道​​除颤、高级气道管理或肾上腺素给药的患者,两组的 CPC 1-2 率相似。

结论

在这项回顾性观察研究的限制范围内,调度员辅助的常规 CPR 优于调度员辅助的仅按压 CPR,作为指导呼叫者执行旁观者 CPR 的最佳 CPR 指令。

更新日期:2021-10-12
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