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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...

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Autores principales: Goto, Yoshikazu, Funada, Akira, Goto, Yumiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
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.
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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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