Incidence, characteristics, and survival following cardiopulmonary resuscitation in the quaternary neonatal intensive care unit.
Incidence, characteristics, and survival following cardiopulmonary resuscitation in the quaternary neonatal intensive care unit.
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DOI：
10.1016/j.resuscitation.2016.10.012
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发表时间：
2017-01
期刊：
影响因子：
6.5
通讯作者：
Nadkarni VM
中科院分区：
文献类型：
--
作者：
Foglia EE;Langeveld R;Heimall L;Deveney A;Ades A;Jensen EA;Nadkarni VM
新生儿重症监护室（NICU）心肺复苏（CPR）的当代特征和结果描述不足。本研究的目的是确定在四级转诊新生儿重症监护室（NICU）中CPR的发生率、干预措施和结局。对2011年4月1日至2015年6月30日期间在费城儿童医院NICU接受胸外按压复苏的婴儿进行的回顾性观察研究。患者、事件和生存特征从医疗记录和医院范围的复苏数据库中提取。主要结局是出院时的生存率。进行单变量和多变量分析，以确定与出院生存率相关的患者和事件因素。每1,000个患者日发生1.2起CPR事件。研究期间，入住NICU的5，046名婴儿中有113名（2.2%）接受了心肺复苏。胸外按压的中位持续时间为2分钟（四分位距1，6分钟）。在34例（30%）CPR事件中给予肾上腺素。在113名至少有一次CPR事件的婴儿中，69名（61%）存活出院。与出院存活率降低独立相关的因素是CPR前的正性肌力药物治疗（校正比值比[aOR] 0.14，95%置信区间[CI] 0.04，0.54）和CPR期间的肾上腺素给药（aOR 0.14，95% CI 0.04，0.50）。虽然这并不罕见，但在四级转诊NICU住院的婴儿中，CPR的发生率较低（<3%）。在心肺复苏术前接受正性肌力治疗和在心肺复苏术期间给予肾上腺素的婴儿存活至出院的可能性较小。
The contemporary characteristics and outcomes of cardiopulmonary resuscitation (CPR) in the neonatal intensive care unit (NICU) are poorly described. The objectives of this study were to determine the incidence, interventions, and outcomes of CPR in a quaternary referral NICU. Retrospective observational study of infants who received chest compressions for resuscitation in the Children’s Hospital of Philadelphia NICU between April 1, 2011 and June 30, 2015. Patient, event, and survival characteristics were abstracted from the medical record and the hospital-wide resuscitation database. The primary outcome was survival to hospital discharge. Univariable and multivariable analyses were performed to identify patient and event factors associated with survival to discharge. There were 1.2 CPR events per 1,000 patient days. CPR was performed in 113 of 5,046 (2.2%) infants admitted to the NICU during the study period. The median duration of chest compressions was 2 minutes (interquartile range 1, 6 minutes). Adrenaline was administered in 34 (30%) CPR events. Of 113 infants with at least one CPR event, 69 (61%) survived to hospital discharge. Factors independently associated with decreased survival to hospital discharge were inotrope treatment prior to CPR (adjusted Odds Ratio [aOR] 0.14, 95% Confidence Interval [CI] 0.04, 0.54), and adrenaline administration during CPR (aOR 0.14, 95% CI 0.04, 0.50). Although it was not uncommon, the incidence of CPR was low (<3%) among infants hospitalized in a quaternary referral NICU. Infants receiving inotropic therapy prior to CPR and adrenaline administration during CPR were less likely to survive to hospital discharge.
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影响因子：
8.8
作者：
Berg RA;Nadkarni VM;Clark AE;Moler F;Meert K;Harrison RE;Newth CJ;Sutton RM;Wessel DL;Berger JT;Carcillo J;Dalton H;Heidemann S;Shanley TP;Zuppa AF;Doctor A;Tamburro RF;Jenkins TL;Dean JM;Holubkov R;Pollack MM;Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
影响因子：
6.5
作者：
Chamnanvanakij, S;Perlman, JM
通讯作者：
Perlman, JM
DOI：
10.1038/sj.jp.7211054
发表时间：
2004-05-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Kostelanetz, Anna S;Dhanireddy, Ramasubbareddy
通讯作者：
Dhanireddy, Ramasubbareddy
DOI：
10.1038/sj.jp.7211174
发表时间：
2004-11-01
期刊：
Journal of perinatology : official journal of the California Perinatal Association
影响因子：
--
作者：
Campbell, Morag E;Byrne, Paul J
通讯作者：
Byrne, Paul J
影响因子：
2
作者：
SOOD, S;GIACOIA, GP
通讯作者：
GIACOIA, GP