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Association Between Chest Compression Pause Duration and Survival After Pediatric In-Hospital Cardiac Arrest.
Kasper G Lauridsen1,2,3, Ryan W Morgan3, Robert A Berg3
1Research Center for Emergency Medicine, Aarhus University, Denmark (K.G.L.).
Circulation
|April 2, 2024
Summary
Longer chest compression pauses in pediatric cardiac arrest decrease survival chances. Minimizing these pauses is crucial for better outcomes in children experiencing in-hospital cardiac arrest.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular research
- Resuscitation science
Background:
- The impact of chest compression (CC) pause duration on pediatric in-hospital cardiac arrest (IHCA) survival is not well-established.
- Current guidelines recommend minimizing CC pauses to under 10 seconds without strong supporting evidence.
- This study investigates the association between CC pause duration and survival outcomes in pediatric IHCA.
Purpose of the Study:
- To examine the relationship between the longest chest compression pause duration and survival outcomes in pediatric in-hospital cardiac arrest.
- To evaluate the association of CC pause duration with survival and favorable neurological outcomes.
- To determine if specific pause durations (>10 or >20 seconds) impact resuscitation success.
Main Methods:
- A cohort study analyzed data from pediatric in-hospital cardiac arrests reported in pediRES-Q from July 2015 to December 2021.
- The longest chest compression pause duration was analyzed in 5-second increments for its association with survival and neurological outcomes.
- Secondary analyses included pauses exceeding 10 or 20 seconds and their frequency.
Main Results:
- Each 5-second increase in the longest CC pause duration was linked to a 3% lower relative risk of survival with favorable neurological outcome (aRR, 0.97; P=0.02).
- Longer CC pauses were also associated with reduced survival to hospital discharge (aRR, 0.98; P=0.01) and return of spontaneous circulation (aRR, 0.93; P<0.001).
- Pauses >10 or >20 seconds, and their frequency, were associated with lower return of spontaneous circulation but not survival or neurological outcomes.
Conclusions:
- Extended chest compression pause durations during pediatric in-hospital cardiac arrest are associated with diminished survival and neurological outcomes.
- Even short, prolonged pauses (>10 or >20 seconds) negatively impact the return of spontaneous circulation.
- These findings underscore the importance of minimizing chest compression interruptions in pediatric resuscitation efforts.
