Journal article
Association between survival and number of shocks for pulseless ventricular arrhythmias during pediatric in-hospital cardiac arrest in a national registry
Resuscitation, Vol.198, 110200
05/2024
DOI: 10.1016/j.resuscitation.2024.110200
PMCID: PMC12150816
PMID: 38582444
Abstract
Annually 15,200 children suffer an in-hospital cardiac arrest (IHCA) in the US. Ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) is the initial rhythm in 10–15% of these arrests. We sought to evaluate the association of number of shocks and early dose escalation with survival for initial VF/pVT in pediatric IHCA.
Using 2000–2020 data from the American Heart Association’s (AHA) Get with the Guidelines®-Resuscitation (GWTG-R) registry, we identified children >48 hours of life and ≤18 years who had an IHCA from initial VF/pVT and received defibrillation.
There were 251 subjects (37.7%) who received a single shock and 415 subjects (62.3%) who received multiple shocks. Baseline and cardiac arrest characteristics did not differ between those who received a single shock versus multiple shocks except for duration of arrest and calendar year. The median first shock dose was consistent with AHA dosing recommendations and not different between those who received a single shock versus multiple shocks. Survival was improved for those who received a single shock compared to multiple shocks. However, no difference in survival was noted between those who received 2, 3, or ≥4 shocks. Of those receiving multiple shocks, no difference was observed with early dose escalation.
In pediatric IHCA, most patients with initial VF/pVT require more than one shock. No distinctions in patient or pre-arrest characteristics were identified between those who received a single shock versus multiple shocks. Subjects who received a single shock were more likely to survive to hospital discharge even after adjusting for duration of resuscitation.
Details
- Title: Subtitle
- Association between survival and number of shocks for pulseless ventricular arrhythmias during pediatric in-hospital cardiac arrest in a national registry
- Creators
- Sarah E. Haskell - University of Iowa Carver College of Medicine, Iowa City, IA, United StatesDerek Hoyme - University of Wisconsin–MadisonM. Bridget Zimmerman - University of IowaRon Reeder - University of UtahSaket Girotra - The University of Texas Southwestern Medical CenterTia T. Raymond - Medical City Children's HospitalRicardo A. Samson - Children's Heart Center NevadaMarc Berg - Stanford University School of MedicineRobert A. Berg - Children's Hospital of PhiladelphiaVinay Nadkarni - Children's Hospital of PhiladelphiaDianne L. Atkins - University of IowaAmerican Heart Association's Get With The Guidelines®-Resuscitation Investigators
- Resource Type
- Journal article
- Publication Details
- Resuscitation, Vol.198, 110200
- DOI
- 10.1016/j.resuscitation.2024.110200
- PMID
- 38582444
- PMCID
- PMC12150816
- NLM abbreviation
- Resuscitation
- ISSN
- 0300-9572
- eISSN
- 1873-1570
- Publisher
- Elsevier B.V
- Grant note
- DOI: 10.13039/100018188, name: Clinical and Translational Science Institute, University of Minnesota; DOI: 10.13039/100000002, name: National Institutes of Health, award: UM1TR004403
- Language
- English
- Electronic publication date
- 04/04/2024
- Date published
- 05/2024
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics; Biostatistics; Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984583619402771
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