关键词: bystander cardiopulmonary resuscitation compression-only cardiopulmonary resuscitation conventional cardiopulmonary resuscitation epidemiologic feature neurologically favorable 1-month survival rate. preschool pediatric out-of-hospital cardiac arrest

来  源:   DOI:10.3389/fped.2022.1075983   PDF(Pubmed)

Abstract:
UNASSIGNED: Pediatric out-of-hospital cardiac arrests (OHCAs) are frequently associated with a respiratory etiology. Despite the high proportion of preschool children with OHCAs, very few studies on this special population exist. This study characterizes the epidemiologic features of preschool pediatric OHCAs and analyzes the advantage of conventional (ventilations with chest compressions) bystander cardiopulmonary resuscitation (CPR) over compression-only bystander CPR (BCPR) on the one-month post-event neurological status of the patient.
UNASSIGNED: Japanese nationwide databases for all ambulance transport events and OHCAs occurring during a 4-year period between 2016 and 2019 were combined, totalling 3,608 patient events. Children ≤6-years-old were included; physician- and EMS-witnessed events, no prehospital resuscitation effort events, and neonatal patient events were excluded. Neurologically favorable 1-month survival rates were compared among groups using univariate and multivariate analyses before and after propensity score matching.
UNASSIGNED: From the combined database, 2,882 pediatric OHCAs meeting selection criteria were categorized as no BCPR (984), compression-only BCPR (1,428), and conventional BCPR (470). The proportion of bystander-witnessed cases was low (22.3%). Most OHCA witnesses were family members (88.5%), and most OHCAs occurred at home (88.0%). The neurologically favorable 1-month survival rates were: no BCPR 2.4%, compression only, 3.2%, and conventional 6.6% (P < 0.01). Multivariate logistic regression analysis before and after matching showed that conventional BCPR was associated with higher neurologically favorable 1-month survival than compression-only BCPR. Subgroup analyses after matching demonstrated that conventional BCPR was associated with better outcomes in nonmedical (adjusted odds ratio; 95% confidence interval, 2.83; 1.09-7.32) and unwitnessed OHCA cases (3.42; 1.09-10.8).
UNASSIGNED: Conventional CPR is rarely performed by bystanders in preschool pediatric OHCA. However, conventional BCPR results in neurologically favorable outcomes in nonmedical and unwitnessed cases.
摘要:
未经证实:小儿院外心脏骤停(OHCA)通常与呼吸道病因有关。尽管患有OHCA的学龄前儿童比例很高,对这种特殊人群的研究很少。这项研究描述了学龄前儿童OHCA的流行病学特征,并分析了常规(胸部按压通气)旁观者心肺复苏(CPR)相对于仅按压旁观者CPR(BCPR)的优势。
UNASSIGNED:在2016年至2019年的4年间发生的所有救护车运输事件和OHCA的日本全国数据库合并在一起,共3,608例患者事件。包括≤6岁的儿童;物理学家和EMS见证的事件,没有院前复苏努力事件,排除新生儿患者事件.在倾向评分匹配之前和之后,使用单变量和多变量分析比较各组之间的神经系统良好的1个月生存率。
UNASSIGNED:从组合数据库,2,882名符合选择标准的儿科OHCA被归类为无BCPR(984),仅压缩BCPR(1,428),和常规BCPR(470)。旁观者见证的病例比例较低(22.3%)。大多数OHCA证人是家庭成员(88.5%),大多数OHCA发生在家中(88.0%)。神经上有利的1个月生存率为:无BCPR2.4%,仅压缩,3.2%,常规6.6%(P<0.01)。匹配前后的多因素logistic回归分析显示,常规BCPR比仅压缩BCPR具有更高的神经系统1个月生存率。匹配后的亚组分析表明,常规BCPR与非医学患者的结局更好(调整后的比值比;95%置信区间,2.83;1.09-7.32)和未见证的OHCA案件(3.42;1.09-10.8)。
UNASSIGNED:在学龄前儿童OHCA中,旁观者很少进行常规CPR。然而,常规BCPR可在非医学和目击病例中获得良好的神经系统结局.
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