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Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study
BACKGROUND: The effect of a subsequent treated shockable rhythm during cardiopulmonary resuscitation on the outcome of children who suffer out‐of‐hospital cardiac arrest with initial nonshockable rhythm is unclear. We hypothesized that subsequent treated shockable rhythm in children with out‐of‐hosp...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121473/ https://www.ncbi.nlm.nih.gov/pubmed/27792647 http://dx.doi.org/10.1161/JAHA.116.003589 |
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author | Goto, Yoshikazu Funada, Akira Goto, Yumiko |
author_facet | Goto, Yoshikazu Funada, Akira Goto, Yumiko |
author_sort | Goto, Yoshikazu |
collection | PubMed |
description | BACKGROUND: The effect of a subsequent treated shockable rhythm during cardiopulmonary resuscitation on the outcome of children who suffer out‐of‐hospital cardiac arrest with initial nonshockable rhythm is unclear. We hypothesized that subsequent treated shockable rhythm in children with out‐of‐hospital cardiac arrest would improve survival with favorable neurological outcomes (Cerebral Performance Category scale 1–2). METHODS AND RESULTS: From the All‐Japan Utstein Registry, we analyzed the records of 12 402 children (aged <18 years) with out‐of‐hospital cardiac arrest and initial nonshockable rhythms. Patients were divided into 2 cohorts: subsequent treated shockable rhythm (YES; n=239) and subsequent treated shockable rhythm (NO; n=12 163). The rate of 1‐month cerebral performance category 1 to 2 in the subsequent treated shockable rhythm (YES) cohort was significantly higher when compared to the subsequent treated shockable rhythm (NO) cohort (4.6% [11 of 239] vs 1.3% [155 of 12 163]; adjusted odds ratio, 2.90; 95% CI, 1.42–5.36; all P<0.001). In the subsequent treated shockable rhythm (YES) cohort, the rate of 1‐month cerebral performance category 1 to 2 decreased significantly as time to shock delivery increased (17.7% [3 of 17] for patients with shock‐delivery time 0–9 minutes, 7.3% [8 of 109] for 10–19 minutes, and 0% [0 of 109] for 20–59 minutes; P<0.001 [for trend]). Age‐stratified outcomes showed no significant differences between the 2 cohorts in the group aged <7 years old: 1.3% versus 1.4%, P=0.62. CONCLUSIONS: In children with out‐of‐hospital cardiac arrest and initial nonshockable rhythms, subsequent treated shockable rhythm was associated with improved 1‐month survival with favorable neurological outcomes. In the cohort of older children (7–17 years), these outcomes worsened as time to shock delivery increased. |
format | Online Article Text |
id | pubmed-5121473 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-51214732016-12-06 Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study Goto, Yoshikazu Funada, Akira Goto, Yumiko J Am Heart Assoc Original Research BACKGROUND: The effect of a subsequent treated shockable rhythm during cardiopulmonary resuscitation on the outcome of children who suffer out‐of‐hospital cardiac arrest with initial nonshockable rhythm is unclear. We hypothesized that subsequent treated shockable rhythm in children with out‐of‐hospital cardiac arrest would improve survival with favorable neurological outcomes (Cerebral Performance Category scale 1–2). METHODS AND RESULTS: From the All‐Japan Utstein Registry, we analyzed the records of 12 402 children (aged <18 years) with out‐of‐hospital cardiac arrest and initial nonshockable rhythms. Patients were divided into 2 cohorts: subsequent treated shockable rhythm (YES; n=239) and subsequent treated shockable rhythm (NO; n=12 163). The rate of 1‐month cerebral performance category 1 to 2 in the subsequent treated shockable rhythm (YES) cohort was significantly higher when compared to the subsequent treated shockable rhythm (NO) cohort (4.6% [11 of 239] vs 1.3% [155 of 12 163]; adjusted odds ratio, 2.90; 95% CI, 1.42–5.36; all P<0.001). In the subsequent treated shockable rhythm (YES) cohort, the rate of 1‐month cerebral performance category 1 to 2 decreased significantly as time to shock delivery increased (17.7% [3 of 17] for patients with shock‐delivery time 0–9 minutes, 7.3% [8 of 109] for 10–19 minutes, and 0% [0 of 109] for 20–59 minutes; P<0.001 [for trend]). Age‐stratified outcomes showed no significant differences between the 2 cohorts in the group aged <7 years old: 1.3% versus 1.4%, P=0.62. CONCLUSIONS: In children with out‐of‐hospital cardiac arrest and initial nonshockable rhythms, subsequent treated shockable rhythm was associated with improved 1‐month survival with favorable neurological outcomes. In the cohort of older children (7–17 years), these outcomes worsened as time to shock delivery increased. John Wiley and Sons Inc. 2016-10-17 /pmc/articles/PMC5121473/ /pubmed/27792647 http://dx.doi.org/10.1161/JAHA.116.003589 Text en © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Goto, Yoshikazu Funada, Akira Goto, Yumiko Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title | Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title_full | Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title_fullStr | Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title_full_unstemmed | Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title_short | Subsequent Shockable Rhythm During Out‐of‐Hospital Cardiac Arrest in Children With Initial Non‐Shockable Rhythms: A Nationwide Population‐Based Observational Study |
title_sort | subsequent shockable rhythm during out‐of‐hospital cardiac arrest in children with initial non‐shockable rhythms: a nationwide population‐based observational study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5121473/ https://www.ncbi.nlm.nih.gov/pubmed/27792647 http://dx.doi.org/10.1161/JAHA.116.003589 |
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