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Does Compliance with Resuscitation Practice Guidelines Differ Between Pediatric Intensive Care Units and Cardiac
Tanya Perry1, Tia T Raymond2, Joanna Fishbein3
1The Heart Institute, Cincinnati Children's Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Journal of Intensive Care Medicine
|March 20, 2023
Summary
Pediatric cardiac arrest resuscitation adherence is similar between cardiac and general pediatric intensive care units. However, extracorporeal cardiopulmonary resuscitation was more frequent in cardiac intensive care units for children with heart disease.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiology
- Resuscitation Science
Background:
- Hospitalized children with cardiac disease face the highest risk of cardiac arrest.
- Existing intensive care unit (ICU) models vary, but differences in resuscitation guideline adherence between cardiac ICUs (CICUs) and general pediatric ICUs (PICUs) are not well understood.
Purpose of the Study:
- To compare resuscitation guideline adherence in children with cardiac disease between CICUs and PICUs.
- To investigate potential differences in adherence to American Heart Association's Get With The Guidelines®-Resuscitation (GWTG-R) and Pediatric Advanced Life Support (PALS) recommendations.
Main Methods:
- Retrospective observational study using the GWTG-R registry (2014-2018).
- Evaluated 886 pediatric patients (<18 years) with cardiac disease who experienced cardiopulmonary arrest.
- Assessed compliance with GWTG-R measures (e.g., time to compressions, epinephrine, shock) and PALS recommendations.
Main Results:
- No significant differences in GWTG-R achievement measures or PALS recommendations between CICUs and PICUs.
- Medication use (amiodarone, lidocaine) also did not differ by unit type.
- Extracorporeal cardiopulmonary resuscitation (ECPR) was significantly more common in CICUs for both medical and surgical cardiac patients.
Conclusions:
- Resuscitation compliance is comparable between CICUs and PICUs for pediatric cardiac patients.
- CICUs utilize ECPR more frequently for these patients.
- Further research is needed to determine if ICU type impacts arrest outcomes in children with cardiac disease.
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