Outcomes of Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories
Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved..
OBJECTIVES: The objective of this study was to determine the association of the use of extracorporeal cardiopulmonary resuscitation (ECPR) with survival to hospital discharge in pediatric patients with a noncardiac illness category. A secondary objective was to report on trends in ECPR usage in this population for 20 years.
DESIGN: Retrospective multicenter cohort study.
SETTING: Hospitals contributing data to the American Heart Association's Get With The Guidelines-Resuscitation registry between 2000 and 2021.
PATIENTS: Children (<18 yr) with noncardiac illness category who received greater than or equal to 30 minutes of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Propensity score weighting balanced ECPR and conventional CPR (CCPR) groups on hospital and patient characteristics. Multivariable logistic regression incorporating these scores tested the association of ECPR with survival to discharge. A Bayesian logistic regression model estimated the probability of a positive effect from ECPR. A secondary analysis explored temporal trends in ECPR utilization. Of 875 patients, 159 received ECPR and 716 received CCPR. The median age was 1.0 [interquartile range: 0.2-7.0] year. Most patients (597/875; 68%) had a primary diagnosis of respiratory insufficiency. Median CPR duration was 45 [35-63] minutes. ECPR use increased over time ( p < 0.001). We did not identify differences in survival to discharge between the ECPR group (21.4%) and the CCPR group (16.2%) in univariable analysis ( p = 0.13) or propensity-weighted multivariable logistic regression (adjusted odds ratio 1.42 [95% CI, 0.84-2.40; p = 0.19]). The Bayesian model estimated an 85.1% posterior probability of a positive effect of ECPR on survival to discharge.
CONCLUSIONS: ECPR usage increased substantially for the last 20 years. We failed to identify a significant association between ECPR and survival to hospital discharge, although a post hoc Bayesian analysis suggested a survival benefit (85% posterior probability).
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
|---|---|
| Enthalten in: |
Critical care medicine - 52(2024), 4 vom: 01. März, Seite 551-562 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Loaec, Morgann [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 15.03.2024 Date Revised 22.03.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1097/CCM.0000000000006153 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366475630 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366475630 | ||
| 003 | DE-627 | ||
| 005 | 20240323234856.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240108s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/CCM.0000000000006153 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1342.xml |
| 035 | |a (DE-627)NLM366475630 | ||
| 035 | |a (NLM)38156912 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Loaec, Morgann |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 15.03.2024 | ||
| 500 | |a Date Revised 22.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. | ||
| 520 | |a OBJECTIVES: The objective of this study was to determine the association of the use of extracorporeal cardiopulmonary resuscitation (ECPR) with survival to hospital discharge in pediatric patients with a noncardiac illness category. A secondary objective was to report on trends in ECPR usage in this population for 20 years | ||
| 520 | |a DESIGN: Retrospective multicenter cohort study | ||
| 520 | |a SETTING: Hospitals contributing data to the American Heart Association's Get With The Guidelines-Resuscitation registry between 2000 and 2021 | ||
| 520 | |a PATIENTS: Children (<18 yr) with noncardiac illness category who received greater than or equal to 30 minutes of cardiopulmonary resuscitation (CPR) for in-hospital cardiac arrest | ||
| 520 | |a INTERVENTIONS: None | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: Propensity score weighting balanced ECPR and conventional CPR (CCPR) groups on hospital and patient characteristics. Multivariable logistic regression incorporating these scores tested the association of ECPR with survival to discharge. A Bayesian logistic regression model estimated the probability of a positive effect from ECPR. A secondary analysis explored temporal trends in ECPR utilization. Of 875 patients, 159 received ECPR and 716 received CCPR. The median age was 1.0 [interquartile range: 0.2-7.0] year. Most patients (597/875; 68%) had a primary diagnosis of respiratory insufficiency. Median CPR duration was 45 [35-63] minutes. ECPR use increased over time ( p < 0.001). We did not identify differences in survival to discharge between the ECPR group (21.4%) and the CCPR group (16.2%) in univariable analysis ( p = 0.13) or propensity-weighted multivariable logistic regression (adjusted odds ratio 1.42 [95% CI, 0.84-2.40; p = 0.19]). The Bayesian model estimated an 85.1% posterior probability of a positive effect of ECPR on survival to discharge | ||
| 520 | |a CONCLUSIONS: ECPR usage increased substantially for the last 20 years. We failed to identify a significant association between ECPR and survival to hospital discharge, although a post hoc Bayesian analysis suggested a survival benefit (85% posterior probability) | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Himebauch, Adam S |e verfasserin |4 aut | |
| 700 | 1 | |a Reeder, Ron |e verfasserin |4 aut | |
| 700 | 1 | |a Alvey, Jessica S |e verfasserin |4 aut | |
| 700 | 1 | |a Race, Jonathan A |e verfasserin |4 aut | |
| 700 | 1 | |a Su, Lillian |e verfasserin |4 aut | |
| 700 | 1 | |a Lasa, Javier J |e verfasserin |4 aut | |
| 700 | 1 | |a Slovis, Julia C |e verfasserin |4 aut | |
| 700 | 1 | |a Raymond, Tia T |e verfasserin |4 aut | |
| 700 | 1 | |a Coleman, Ryan |e verfasserin |4 aut | |
| 700 | 1 | |a Barney, Bradley J |e verfasserin |4 aut | |
| 700 | 1 | |a Kilbaugh, Todd J |e verfasserin |4 aut | |
| 700 | 1 | |a Topjian, Alexis A |e verfasserin |4 aut | |
| 700 | 1 | |a Sutton, Robert M |e verfasserin |4 aut | |
| 700 | 1 | |a Morgan, Ryan W |e verfasserin |4 aut | |
| 700 | 0 | |a American Heart Association’s (AHA) Get With The Guidelines-Resuscitation (GWTG-R) Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Guerguerian, Anne-Marie |e investigator |4 oth | |
| 700 | 1 | |a O'Brien, Caitlin E |e investigator |4 oth | |
| 700 | 1 | |a Fink, Ericka L |e investigator |4 oth | |
| 700 | 1 | |a Lasa, Javier J |e investigator |4 oth | |
| 700 | 1 | |a Roberts, Joan S |e investigator |4 oth | |
| 700 | 1 | |a Su, Lillian |e investigator |4 oth | |
| 700 | 1 | |a Brown, Linda L |e investigator |4 oth | |
| 700 | 1 | |a Dewan, Maya |e investigator |4 oth | |
| 700 | 1 | |a Bembea, Melania M |e investigator |4 oth | |
| 700 | 1 | |a Kleinman, Monica |e investigator |4 oth | |
| 700 | 1 | |a Ali, Noorjahan |e investigator |4 oth | |
| 700 | 1 | |a Gupta, Punkaj |e investigator |4 oth | |
| 700 | 1 | |a Sutton, Robert M |e investigator |4 oth | |
| 700 | 1 | |a Reeder, Ron |e investigator |4 oth | |
| 700 | 1 | |a Sweberg, Todd |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t Critical care medicine |d 1973 |g 52(2024), 4 vom: 01. März, Seite 551-562 |w (DE-627)NLM000002631 |x 1530-0293 |7 nnns |
| 773 | 1 | 8 | |g volume:52 |g year:2024 |g number:4 |g day:01 |g month:03 |g pages:551-562 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/CCM.0000000000006153 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 52 |j 2024 |e 4 |b 01 |c 03 |h 551-562 | ||