Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing.
Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing.
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DOI：
10.1097/ccm.0b013e31828cf0c0
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发表时间：
2013-10
影响因子：
8.8
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network and for the American Heart Association’s Get With the Guidelines-Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) Investigators
中科院分区：
文献类型：
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作者：
Berg RA;Sutton RM;Holubkov R;Nicholson CE;Dean JM;Harrison R;Heidemann S;Meert K;Newth C;Moler F;Pollack M;Dalton H;Doctor A;Wessel D;Berger J;Shanley T;Carcillo J;Nadkarni VM;Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network and for the American Heart Association’s Get With the Guidelines-Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) Investigators
本研究的目的是评估重症监护病房 (ICU) 与普通病房相比，儿科院内心肺复苏事件发生的相对频率。我们假设，在过去十年中，与普通病房相比，ICU 提供的儿科心肺复苏的比例有所增加，这种转变与复苏结果的改善有关。前瞻性、观察性研究。美国心脏协会 Get With TheGuidelines-Resusitation (GTWG-R) 数据库中共有 315 家医院。 2000 年 1 月 1 日至 2010 年 9 月 14 日期间，总共发生了 5,870 起儿童心肺复苏 (CPR) 事件。CPR 事件定义为胸外按压 >1 分钟。主要结局是 ICU 与普通病房 CPR 事件随时间变化的比例，通过卡方检验趋势进行评估。次要结局包括心肺复苏后自主循环（ROSC）的恢复。在 5870 起儿童心肺复苏事件中，5477 起 (93.3%) 发生在 ICU，而 393 起 (6.7%) 发生在住院病房。随着时间的推移，与病房相比，ICU 中发生的 CPR 事件显着增多（趋势检验：p<0.01），2003 年至 2004 年之间发生了显着变化（2000-2003 年：87 - 91% 与 2004-2010 年：94 - 96%）。在控制中心变异性和其他潜在混杂因素的多变量模型中，与 2000-2003 年相比，2004-2010 年 ROSC 有所增加（RR 1.08，95% 置信区间：1.03-1.13）。与病房相比，院内儿科心肺复苏在 ICU 中更为常见，并且这一比例在过去十年中显着增加，同时自主循环恢复也随之增加。
The aim of this study was to evaluate the relative frequency of pediatric in-hospital CPR events occurring in intensive care units (ICUs) compared to general wards. We hypothesized that the proportion of pediatric CPR provided in ICUs versus general wards has increased over the past decade and this shift is associated with improved resuscitation outcomes. Prospective, observational study. Total of 315 hospitals in the American Heart Association’s Get With The Guidelines-Resuscitation (GTWG-R) database. Total of 5,870 pediatric cardiopulmonary resuscitation (CPR) events between January 1, 2000 and September 14, 2010. CPR events were defined as external chest compressions >1minute. The primary outcome was proportion of total ICU versus general ward CPR events over time evaluated by chi square test for trend. Secondary outcome included return of spontaneous circulation (ROSC) following the CPR event. Among 5870 pediatric CPR events, 5477 (93.3%) occurred in ICUs compared to 393 (6.7%) on inpatient wards. Over time, significantly more of these CPR events occurred in the ICU compared to the wards (test for trend: p<0.01), with a prominent shift noted between 2003 and 2004 (2000-2003: 87 - 91% vs. 2004-2010: 94 - 96%). In a multivariable model controlling for within center variability and other potential confounders, ROSC increased in 2004-2010 compared with 2000-2003 (RR 1.08, 95% confidence interval: 1.03-1.13). In-hospital pediatric CPR is much more commonly provided in ICUs vs. Wards and the proportion has increased significantly over the past decade with concomitant increases in return of spontaneous circulation.