Abstract
Abstract 246: Defibrillation For Pulseless Ventricular Arrhythmias During Pediatric In-hospital Cardiac Arrest: A Report From The AHA Get With The Guidelinesë-Resuscitation Registry
Circulation (New York, N.Y.), Vol.146(S_1), p.A246
11/08/2022
DOI: 10.1161/circ.146.suppl_1.246
Abstract
Byline: Sarah E Haskell, Pediatrics, UNIVERSITY OF IOWA, Iowa City, IA; Derek Hoyme, Univ of Wisconsin Madison, Madison, WI; Saket Girotra, Univ of Iowa, Iowa City, IA; M Bridget Zimmerman, Univ of Iowa, Iowa City, IA; Ron Reeder, Salt Lake City, UT; Tia T Raymond, Dallas, TX; Ricardo Samson, Children's Heart Cntr - Nevada, Las Vegas, NV; Marc Berg, Stanford Univ, Menlo Park, CA; Robert A Berg, CHILDRENS HOSPITAL OF PHILADELPHIA, Philadelphia, PA; Vinay M Nadkarni, Children's Hospital of Philadelphia, Philadelphia, PA; Dianne L Atkins, Univ of Iowa, Iowa City, IA Introduction: Approximately 15,200 children suffer an in-hospital cardiac arrest (IHCA) annually, and 10-20% will have ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT). Timely defibrillation is critical for shockable rhythms, however current data are lacking on outcomes when > 1 shock is required for termination of VF/pVT. Methods: From the AHA Get With The Guidelinesë-Resuscitation registry, we identified children < 18 years of age who had IHCA from initial VF/pVT and received > 1 shock from 2000-2020. Patients were analyzed according to total number of shocks received: 2 shocks, 3 shocks, or > 4 shocks. Multivariable logistic regression models were used to test the association between number of shocks and return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with favorable neurologic outcome. Results: 436 patients met inclusion criteria and received > 1 shock for VF/pVT. Median age was 8 years [IQR, 0.9,15.0]. Patients that required > 4 shocks were older patients (11 years [1.0-15.0; p=0.013]). A higher percentage of patients receiving > 4 shocks had renal insufficiency (14% vs. 7% for 2 shocks vs. 6% for 3 shocks, p = 0.041). Patients receiving > 4 shocks vs. 2 shocks were less likely to achieve ROSC (OR 0.40 [0.23,0.68]; p=0.0009). There was no statistically significant difference in survival to hospital discharge for patients receiving 2 shocks (42%), 3 shocks (39%), or > 4 shocks (32%) or survival to hospital discharge with favorable neurologic outcome. Conclusion: There was no significant association between the number of shocks and survival to hospital discharge or survival to hospital discharge with favorable neurologic outcome. ROSC was significantly less in patients with > 4 shocks for VF/pVT compared to 2 shocks. Further research is needed to characterize energy dosing when > 1 shock is needed for VF/pVT.
Details
- Title: Subtitle
- Abstract 246: Defibrillation For Pulseless Ventricular Arrhythmias During Pediatric In-hospital Cardiac Arrest: A Report From The AHA Get With The Guidelinesë-Resuscitation Registry
- Creators
- Sarah E HaskellDerek HoymeSaket GirotraM Bridget ZimmermanRon ReederTia T RaymondRicardo Samson
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.146(S_1), p.A246
- Publisher
- Lippincott Williams & Wilkins, WK Health
- DOI
- 10.1161/circ.146.suppl_1.246
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/08/2022
- Description audience
- Professional
- Academic Unit
- Cardiovascular Medicine; Biostatistics; Internal Medicine; Stead Family Department of Pediatrics; Critical Care
- Record Identifier
- 9984354395602771
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