Outcomes of Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories.
Outcomes of Extracorporeal Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest Among Children With Noncardiac Illness Categories.
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非心脏疾病类别儿童院内心脏骤停的体外心肺复苏的结果。
DOI：
10.1097/ccm.0000000000006153
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发表时间：
2024
影响因子：
8.8
通讯作者：
Amer
中科院分区：
文献类型：
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作者：
Loaec,Morgann;Himebauch,AdamS;Reeder,Ron;Alvey,JessicaS;Race,JonathanA;Su,Lillian;Lasa,JavierJ;Slovis,JuliaC;Raymond,TiaT;Coleman,Ryan;Barney,BradleyJ;Kilbaugh,ToddJ;Topjian,AlexisA;Sutton,RobertM;Morgan,RyanW;Amer
目的：本研究的目的是确定体外循环心肺复苏术(ECPR)的使用与非心脏疾病类别的儿童患者出院后存活时间的关系。第二个目标是报告20年来ECPR在该人群中的使用趋势。设计：回顾性多中心队列研究。设置：医院在2000年至2021年期间向美国心脏协会的GET指南-复苏登记提供数据。研究对象：患有非心脏疾病类别的儿童(18岁)，因住院心脏骤停而接受大于或等于30分钟的心肺复苏(CPR)。INTERVENTIONS：非测量ECPR和传统CPR(CCPR)组在医院和患者特征上的倾向分数加权。结合这些评分的多变量Logistic回归检验了ECPR与存活至出院的相关性。贝叶斯Logistic回归模型估计了ECPR产生积极效果的概率。二次分析探讨了ECPR使用的时间趋势。在875名患者中，159名患者接受了ECPR，716名患者接受了CCPR。中位年龄为1.0[四分位数范围：0.2-7.0]岁。大多数患者(597/875；68%)最初诊断为呼吸功能不全。CPR持续时间中位数为45[35~63]分钟。ECPR的使用量随着时间的推移而增加(p<；0.001)。在单变量分析(p=0.13)或倾向加权多变量Logistic回归(调整后的优势比1.42[95%CI，0.84-2.40；p=0.19])中，我们没有发现ECPR组(21.4%)和CCPR组(16.2%)之间的生存到出院的差异。贝叶斯模型估计ECPR对存活至出院有积极影响的后验概率为85.1%。结论：在过去的20年中，ECPR的使用大幅增加。我们未能确定心肺复苏和出院后存活率之间的显著关联，尽管特别的贝叶斯分析表明存活率有好处(85%的后验概率)。
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).
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影响因子：
37.8
作者：
Topjian, Alexis A.;Raymond, Tia T.;Schexnayder, Stephen M.
通讯作者：
Schexnayder, Stephen M.
2019心肺复苏和心血管急救科学国际共识及治疗建议：基本生命支持总结；
影响因子：
37.8
作者：
J. Soar;I. Maconochie;M. Wyckoff;T. Olasveengen;E. Singletary;R. Greif;R. Aickin;F. Bhanji;M. Donnino;M. Mancini;J. Wyllie;D. Zideman;L. Andersen;D. Atkins;K. Aziz;J. Bendall;K. Berg;D. Berry;B. Bigham;R. Bingham;T. B. Couto;B. Böttiger;V. Borra;J. Bray;J. Breckwoldt;S. Brooks;Jason E. Buick;C. Callaway;J. Carlson;P. Cassan;M. Castrén;Wei;Nathan P. Charlton;A. Cheng;S. Chung;J. Considine;K. Couper;K. Dainty;J. Dawson;M. D. de Almeida;A. D. De Caen;C. Deakin;I. Drennan;J. Duff;Jonathan L. Epstein;R. Escalante;R. Gazmuri;E. Gilfoyle;A. Granfeldt;A. Guerguerian;R. Guinsburg;Tetsuo Hatanaka;M. Holmberg;Natalie A. Hood;S. Hosono;M. Hsieh;T. Isayama;Taku Iwami;J. Jensen;V. Kapadia;H. Kim;M. Kleinman;P. Kudenchuk;E. Lang;E. Lavonas;H. Liley;S. Lim;A. Lockey;B. Løfgren;M. Ma;D. Markenson;P. Meaney;D. Meyran;L. Mildenhall;K. Monsieurs;W. Montgomery;P. Morley;L. Morrison;V. Nadkarni;K. Nation;R. Neumar;K. Ng;T. Nicholson;N. Nikolaou;C. Nishiyama;G. Nuthall;S. Ohshimo;Deems Okamoto;B. O’Neil;G. Ong;E. Paiva;M. Parr;Jeffrey L Pellegrino;G. Perkins;J. Perlman;Y. Rabi;A. Reis;J. Reynolds;G. Ristagno;C. Roehr;T. Sakamoto;C. Sandroni;S. Schexnayder;B. Scholefield;N. Shimizu;M. Skrifvars;M. Smyth;D. Stanton;J. Swain;E. Szyld;J. Tijssen;A. Travers;D. Trevisanuto;C. Vaillancourt;P. Van de Voorde;S. Velaphi;Tzong;G. Weiner;M. Welsford;Jeff A. Woodin;J. Yeung;J. Nolan;M. Hazinski
通讯作者：
M. Hazinski
影响因子：
1.6
作者：
通讯作者：
--
影响因子：
6.5
作者：
Nolan, Jerry P.;Berg, Robert A.;Welsford, Michelle
通讯作者：
Welsford, Michelle
DOI：
10.1001/jama.2015.13480
发表时间：
2015-10-20
期刊：
JAMA
影响因子：
--
作者：
Haukoos JS;Lewis RJ
通讯作者：
Lewis RJ