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1. Trends in community response and long-term outcomes from pediatric cardiac arrest:A retrospective observational study

Author

Albrecht, M, de Jonge, R C J, Dulfer, K, Van Gils-Frijters, A P J M, de Hoog, M, Hunfeld, M, Kammeraad, J A E, Moors, X R J, Nadkarni, V M, Buysse, C M P, Albrecht, M, de Jonge, R C J, Dulfer, K, Van Gils-Frijters, A P J M, de Hoog, M, Hunfeld, M, Kammeraad, J A E, Moors, X R J, Nadkarni, V M, and Buysse, C M P

Abstract

AIM: This study aimed to investigate trends over time in pre-hospital factors for pediatric out-of-hospital cardiac arrest (pOHCA) and long-term neurological and neuropsychological outcomes. These have not been described before in large populations.METHODS: Non-traumatic arrest patients, 1 day-17 years old, presented to the Sophia Children's Hospital from January 2002 to December 2020, were eligible for inclusion. Favorable neurological outcome was defined as Pediatric Cerebral Performance Categories (PCPC) 1-2 or no difference with pre-arrest baseline. The trend over time was tested with multivariable logistic and linear regression models with year of event as independent variable.FINDINGS: Over a nineteen-year study period, the annual rate of long-term favorable neurological outcome, assessed at a median 2·5 years follow-up, increased significantly (OR 1·10, 95%-CI 1·03-1·19), adjusted for confounders. Concurrently, annual automated external defibrillator (AED) use and, among adolescents, initial shockable rhythm increased significantly (OR 1·21, 95% CI 1·10-1·33 and OR 1·15, 95% CI 1·02-1·29, respectively), adjusted for confounders. For generalizability purposes, only the total intelligence quotient (IQ) was considered for trend analysis of all tested domains. Total IQ scores and bystander basic life support (BLS) rate did not change significantly over time.INTERPRETATION: Long-term favorable neurological outcome, assessed at a median 2·5 years follow-up, improved significantly over the study period. Total IQ scores did not significantly change over time. Furthermore, AED use (OR 1·21, 95%CI 1.10-1·33) and shockable rhythms among adolescents (OR1·15, 95%CI 1·02-1·29) increased over time.

Published
2024

2. Association between shockable rhythms and long-term outcome after pediatric out-of-hospital cardiac arrest in Rotterdam, the Netherlands: An 18-year observational study

Author

Albrecht, M., de Jonge, R. C.J., Nadkarni, V. M., de Hoog, M., Hunfeld, M., Kammeraad, J. A.E., van Zellem, L., Moors, X. R.J., Buysse, C. M.P., Pediatric Surgery, Pediatrics, Neurology, Anesthesiology, and Erasmus MC other

Subjects
Male, Emergency Medical Services, medicine.medical_specialty, Adolescent, Emergency Nursing, Return of spontaneous circulation, Out of hospital cardiac arrest, Cohort Studies, Rhythm, medicine, Humans, Child, Netherlands, Retrospective Studies, Pediatric intensive care unit, business.industry, Shockable rhythm, Emergency department, Cardiopulmonary Resuscitation, Child, Preschool, Emergency medicine, Cohort, Emergency Medicine, Observational study, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest
Abstract

Introduction Shockable rhythm following pediatric out-of-hospital cardiac arrest (pOHCA) is consistently associated with hospital and short-term survival. Little is known about the relationship between shockable rhythm and long-term outcomes (>1 year) after pOHCA. The aim was to investigate the association between first documented rhythm and long-term outcomes in a pOHCA cohort over 18 years. Methods All children aged 1 day–18 years who experienced non-traumatic pOHCA between 2002–2019 and were subsequently admitted to the emergency department (ED) or pediatric intensive care unit (PICU) of Erasmus MC-Sophia Children’s Hospital were included. Data was abstracted retrospectively from patient files, (ground) ambulance and Helicopter Emergency Medical Service (HEMS) records, and follow-up clinics. Long-term outcome was determined using a Pediatric Cerebral Performance Category (PCPC) score at the longest available follow-up interval through august 2020. The primary outcome measure was survival with favorable neurologic outcome, defined as PCPC 1–2 or no difference between pre- and post-arrest PCPC. The association between first documented rhythm and the primary outcome was calculated in a multivariable regression model. Results 369 children were admitted, nine children were lost to follow-up. Median age at arrest was age 3.4 (IQR 0.8–9.9) years, 63% were male and 14% had a shockable rhythm (66% non-shockable, 20% unknown or return of spontaneous circulation (ROSC) before emergency medical service (EMS) arrival). In adolescents (aged 12–18 years), 39% had shockable rhythm. 142 (39%) of children survived to hospital discharge. On median follow-up interval of 25 months (IQR 5.1–49.6), 115/142 (81%) of hospital survivors had favorable neurologic outcome. In multivariable analysis, shockable rhythm was associated with survival with favorable long-term neurologic outcome (OR 8.9 [95%CI 3.1–25.9]). Conclusion In children with pOHCA admitted to ED or PICU shockable rhythm had significantly higher odds of survival with long-term favorable neurologic outcome compared to non-shockable rhythm. Survival to hospital discharge after pOHCA was 39% over the 18-year study period. Of survivors to discharge, 81% had favorable long-term (median 25 months, IQR 5.1–49.6) neurologic outcome. Efforts for improving outcome of pOHCA should focus on early recognition and treatment of shockable pOHCA at scene.

Published
2021

3. Association between shockable rhythms and long-term outcome after pediatric out-of-hospital cardiac arrest in Rotterdam, the Netherlands:An 18-year observational study

Author

Albrecht, M., de Jonge, R. C.J., Nadkarni, V. M., de Hoog, M., Hunfeld, M., Kammeraad, J. A.E., van Zellem, L., Moors, X. R.J., Buysse, C. M.P., Albrecht, M., de Jonge, R. C.J., Nadkarni, V. M., de Hoog, M., Hunfeld, M., Kammeraad, J. A.E., van Zellem, L., Moors, X. R.J., and Buysse, C. M.P.

Abstract

Introduction: Shockable rhythm following pediatric out-of-hospital cardiac arrest (pOHCA) is consistently associated with hospital and short-term survival. Little is known about the relationship between shockable rhythm and long-term outcomes (>1 year) after pOHCA. The aim was to investigate the association between first documented rhythm and long-term outcomes in a pOHCA cohort over 18 years. Methods: All children aged 1 day–18 years who experienced non-traumatic pOHCA between 2002–2019 and were subsequently admitted to the emergency department (ED) or pediatric intensive care unit (PICU) of Erasmus MC-Sophia Children's Hospital were included. Data was abstracted retrospectively from patient files, (ground) ambulance and Helicopter Emergency Medical Service (HEMS) records, and follow-up clinics. Long-term outcome was determined using a Pediatric Cerebral Performance Category (PCPC) score at the longest available follow-up interval through august 2020. The primary outcome measure was survival with favorable neurologic outcome, defined as PCPC 1–2 or no difference between pre- and post-arrest PCPC. The association between first documented rhythm and the primary outcome was calculated in a multivariable regression model. Results: 369 children were admitted, nine children were lost to follow-up. Median age at arrest was age 3.4 (IQR 0.8–9.9) years, 63% were male and 14% had a shockable rhythm (66% non-shockable, 20% unknown or return of spontaneous circulation (ROSC) before emergency medical service (EMS) arrival). In adolescents (aged 12–18 years), 39% had shockable rhythm. 142 (39%) of children survived to hospital discharge. On median follow-up interval of 25 months (IQR 5.1–49.6), 115/142 (81%) of hospital survivors had favorable neurologic outcome. In multivariable analysis, shockable rhythm was associated with survival with favorable long-term neurologic outcome (OR 8.9 [95%CI 3.1–25.9]). Conclusion: In children with pOHCA admitted to ED or PICU shockable r

Published
2021

7. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Summary from the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; And First Aid Task Forces

Author

Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Yong-Kwang Ong, G., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van De Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Fran Hazinski, M., Sandroni C. (ORCID:0000-0002-8878-2611), Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., De Almeida, M. F., De Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Yong-Kwang Ong, G., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van De Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Fran Hazinski, M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Published
2019

8. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., de Almeida, M. F., de Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Ong, G. Y. -K., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, C., Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van de Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Hazinski, M. F., Sandroni C. (ORCID:0000-0002-8878-2611), Soar, J., Maconochie, I., Wyckoff, M. H., Olasveengen, T. M., Singletary, E. M., Greif, R., Aickin, R., Bhanji, F., Donnino, M. W., Mancini, M. E., Wyllie, J. P., Zideman, D., Andersen, L. W., Atkins, D. L., Aziz, K., Bendall, J., Berg, K. M., Berry, D. C., Bigham, B. L., Bingham, R., Couto, T. B., Bottiger, B. W., Borra, V., Bray, J. E., Breckwoldt, J., Brooks, S. C., Buick, J., Callaway, C. W., Carlson, J. N., Cassan, P., Castren, M., Chang, W. -T., Charlton, N. P., Cheng, A., Chung, S. P., Considine, J., Couper, K., Dainty, K. N., Dawson, J. A., de Almeida, M. F., de Caen, A. R., Deakin, C. D., Drennan, I. R., Duff, J. P., Epstein, J. L., Escalante, R., Gazmuri, R. J., Gilfoyle, E., Granfeldt, A., Guerguerian, A. -M., Guinsburg, R., Hatanaka, T., Holmberg, M. J., Hood, N., Hosono, S., Hsieh, M. -J., Isayama, T., Iwami, T., Jensen, J. L., Kapadia, V., Kim, H. -S., Kleinman, M. E., Kudenchuk, P. J., Lang, E., Lavonas, E., Liley, H., Lim, S. H., Lockey, A., Lofgren, B., Ma, M. H. -M., Markenson, D., Meaney, P. A., Meyran, D., Mildenhall, L., Monsieurs, K. G., Montgomery, W., Morley, P. T., Morrison, L. J., Nadkarni, V. M., Nation, K., Neumar, R. W., Ng, K. -C., Nicholson, T., Nikolaou, N., Nishiyama, C., Nuthall, G., Ohshimo, S., Okamoto, D., O'Neil, B., Ong, G. Y. -K., Paiva, E. F., Parr, M., Pellegrino, J. L., Perkins, G. D., Perlman, J., Rabi, Y., Reis, A., Reynolds, J. C., Ristagno, G., Roehr, C. C., Sakamoto, T., Sandroni, C., Schexnayder, S. M., Scholefield, B. R., Shimizu, N., Skrifvars, M. B., Smyth, M. A., Stanton, D., Swain, J., Szyld, E., Tijssen, J., Travers, A., Trevisanuto, D., Vaillancourt, C., Van de Voorde, P., Velaphi, S., Wang, T. -L., Weiner, G., Welsford, M., Woodin, J. A., Yeung, J., Nolan, J. P., Hazinski, M. F., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

Published
2019

9. Cardiac Arrest and Cardiopulmonary Resuscitation Outcome Reports: Update of the Utstein Resuscitation Registry Template for In-Hospital Cardiac Arrest: A Consensus Report From a Task Force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia)

Author

Nolan, J. P., Berg, R. A., Andersen, L. W., Bhanji, F., Chan, P. S., Donnino, M. W., Lim, S. H., Ma, M. H. -M., Nadkarni, V. M., Starks, M. A., Perkins, G. D., Morley, P. T., Soar, J., Aickin, R., Atkins, D. L., Berg, K. M., Bingham, R., Bottiger, B. W., Brooks, S. C., Callaway, C. W., Castren, M., Chung, S. P., Considine, J., Couto, T. B., de Caen, A. R., Deakin, C. D., Drennan, I. R., Escalante, R., Gazmuri, R. J., Guerguerian, A. -M., Hazinski, M. F., Kudenchuk, P. J., Lofgren, B., Maconochie, I., Mancini, M. E., Meaney, P. A., Neumar, R. W., Ng, K. -C., Nicholson, T. C., Nishiyama, C., Nuthall, G. A., Olasveengen, T. M., Paiva, E. F., Parr, M. J., Reis, A. G., Reynolds, J. C., Ristagno, G., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Smyth, M. A., Stanton, D., Tijssen, J. A., Vaillancourt, C., Van de Voorde, P., Wang, T. -L., Welsford, M., Sandroni C. (ORCID:0000-0002-8878-2611), Nolan, J. P., Berg, R. A., Andersen, L. W., Bhanji, F., Chan, P. S., Donnino, M. W., Lim, S. H., Ma, M. H. -M., Nadkarni, V. M., Starks, M. A., Perkins, G. D., Morley, P. T., Soar, J., Aickin, R., Atkins, D. L., Berg, K. M., Bingham, R., Bottiger, B. W., Brooks, S. C., Callaway, C. W., Castren, M., Chung, S. P., Considine, J., Couto, T. B., de Caen, A. R., Deakin, C. D., Drennan, I. R., Escalante, R., Gazmuri, R. J., Guerguerian, A. -M., Hazinski, M. F., Kudenchuk, P. J., Lofgren, B., Maconochie, I., Mancini, M. E., Meaney, P. A., Neumar, R. W., Ng, K. -C., Nicholson, T. C., Nishiyama, C., Nuthall, G. A., Olasveengen, T. M., Paiva, E. F., Parr, M. J., Reis, A. G., Reynolds, J. C., Ristagno, G., Sandroni, Claudio, Schexnayder, S. M., Scholefield, B. R., Smyth, M. A., Stanton, D., Tijssen, J. A., Vaillancourt, C., Van de Voorde, P., Wang, T. -L., Welsford, M., and Sandroni C. (ORCID:0000-0002-8878-2611)

Abstract

Utstein-style reporting templates provide a structured framework with which to compare systems of care for cardiac arrest. The 2004 Utstein reporting template encompassed both out-of-hospital and in-hospital cardiac arrest. A 2015 update of the Utstein template focused on out-of-hospital cardiac arrest, which makes this update of the in-hospital template timely. Representatives of the International Liaison Committee on Resuscitation developed an updated in-hospital Utstein reporting template iteratively by meeting face-to-face, by teleconference, and by online surveys between 2013 and 2018. Data elements were grouped by hospital factors, patient variables, pre-event factors, cardiac arrest and postresuscitation processes, and outcomes. Elements were classified as core or supplemental by use of a modified Delphi process. Variables were described as core if they were considered essential. Core variables should enable reasonable comparisons between systems and are considered essential for quality improvement programs. Together with core variables, supplementary variables are considered useful for research.

Published
2019

10. 2017 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary

Author

Olasveengen, T. M., de Caen, A. R., Mancini, M. E., Maconochie, I. K., Aickin, R., Atkins, D. L., Berg, R. A., Bingham, R. M., Brooks, S. C., Castrén, M., Chung, S. P., Considine, J. A., Couto, T. B., Escalante, R., Gazmuri, R. J., Guerguerian, A-M., Hatanaka, T., Koster, R. W., Kudenchuk, P. J., Lang, E., Lim, S. H., Løfgren, B., Meaney, P. A., Montgomery, W. H., Morley, P. T., Morrison, L. J., Nation, K. J., Ng, K-C., Nadkarni, V. M., Nishiyama, C., Nuthall, G., Ong, GY-K., Perkins, G. D., Reis, A. G., Ristagno, G., Sakamoto, T., Sayre, M. R., Schexnayder, S. M., Sierra, A. F., Singletary, E. M., Shimizu, N., Smyth, M. A., Stanton, D., Tijssen, J. A., Travers, A., Vaillancourt, C., Van de Voorde, P., Hazinski, M. F., Nolan, J. P., ILCOR Collaborators, Olasveengen, T. M., de Caen, A. R., Mancini, M. E., Maconochie, I. K., Aickin, R., Atkins, D. L., Berg, R. A., Bingham, R. M., Brooks, S. C., Castrén, M., Chung, S. P., Considine, J. A., Couto, T. B., Escalante, R., Gazmuri, R. J., Guerguerian, A-M., Hatanaka, T., Koster, R. W., Kudenchuk, P. J., Lang, E., Lim, S. H., Løfgren, B., Meaney, P. A., Montgomery, W. H., Morley, P. T., Morrison, L. J., Nation, K. J., Ng, K-C., Nadkarni, V. M., Nishiyama, C., Nuthall, G., Ong, GY-K., Perkins, G. D., Reis, A. G., Ristagno, G., Sakamoto, T., Sayre, M. R., Schexnayder, S. M., Sierra, A. F., Singletary, E. M., Shimizu, N., Smyth, M. A., Stanton, D., Tijssen, J. A., Travers, A., Vaillancourt, C., Van de Voorde, P., Hazinski, M. F., Nolan, J. P., and ILCOR Collaborators

Published
2017

23. RC--a case of ornithine transcarbamylase (OTC) deficiency. The most commonly genetically acquired urea cycle defect.

Author

Morra DR, Nadkarni VM, Bartoshesky LE, and Finkelstein MS

Subjects
Blood Chemical Analysis, Child, Preschool, Disease Progression, Fatal Outcome, Female, Humans, Liver Function Tests, Magnetic Resonance Imaging, Ornithine Carbamoyltransferase Deficiency Disease genetics, Ornithine Carbamoyltransferase Deficiency Disease metabolism, Tomography, X-Ray Computed, Ornithine Carbamoyltransferase Deficiency Disease diagnosis, Urea metabolism
Published
2000

24. Clarification of related publications.

Author

Jasani MS, Nadkarni VM, Finkelstein MS, Hofmann WT, and Salzman SK

Subjects
Animals, Cardiopulmonary Resuscitation, Disease Models, Animal, Epinephrine therapeutic use, Instillation, Drug, Intubation, Intratracheal, Swine, Asphyxia drug therapy, Epinephrine administration & dosage
Published
1995
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25. Inspiratory-cycle instillation of endotracheal epinephrine in porcine arrest.

Author

Jasani MS, Nadkarni VM, Finkelstein MS, Hofmann WT, and Salzman SK

Subjects
Animals, Cardiopulmonary Resuscitation, Drug Administration Routes, Epinephrine pharmacokinetics, Epinephrine therapeutic use, Instillation, Drug, Lung metabolism, Prospective Studies, Swine, Tissue Distribution, Drug Delivery Systems, Epinephrine administration & dosage, Heart Arrest drug therapy, Respiration, Artificial
Abstract

Objective: To compare timed inspiratory-cycle endotracheal (ET) instillation of epinephrine (EPI) with instillation during apnea during CPR., Methods: Prospective randomized laboratory comparison of two ET-EPI instillation techniques in 24 preadolescent anesthetized and paralyzed Yucatan swine (mean weight 10.3 +/- 1.5 kg) with apnea-induced hypoxic and hypercarbic cardiopulmonary arrest. After 8 minutes of cardiopulmonary arrest and 1 minute of CPR, 500 microgram(s) (50 +/- 7 microgram(s)/kg) of radiolabeled ET EPI was either administered timed to a ventilator inpspiratory cycle (IN, n = 15) or injected during apnea (DA, n = 9) using a monitoring lumen built into the sidewall of the ET tube. Injection technique was carefully controlled regarding ET-tube position, dilution, flush, and pressure-limited mechanical ventilations. CPR was resumed and continued for 5 minutes. If resuscitation occurred, monitoring was continued for one hour. Outcome variables included pulmonary EPI distribution pattern (DIST), plasma exogenous and total EPI levels, successful resuscitation, and hemodynamic response., Results: Bilateral DIST occurred in 58% of the pigs, with significantly more bilateral DISTs for IN versus DA pigs (p = 0.01). Plasma radiolabeled exogenous EPI counts were significantly greater for IN versus DA pigs (p = 0.03). Total plasma EPI levels rose significantly above baseline over time within each group, but showed no difference between the IN and DA groups at any time point. Successful resuscitation occurred in 21% of the pigs, with no difference between IN and DA pigs (p = 0.38)., Conclusion: When other aspects of ET EPI instillation are optimized and controlled during porcine hypoxic-hypercarbic arrest, timed inspiratory-cycle installation of ET EPI (50 microgram(s)/kg) results in an improved bilateral DIST and greater exogenous EPI absorption. However, in this severe pediatric asphyxial arrest model using a 50-microgram(s)/kg dose, inspiratory-cycle instillation does not improve the resuscitation rate or hemodynamic response over currently recommended instillation during apnea.

Published
1994
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