Abstract：
To determine the association between presence of an advanced airway during pediatric cardiopulmonary resuscitation (CPR) and ventilation rates.
Prospective observational study, January 2017 to June 2020. Patients ≤18 years receiving CC for ≥2 minutes were enrolled. Ventilation rate and type of airway (advanced airway (AA), either endotracheal tube (ETT) or supraglottic airway (SGA); or natural airway (NA)) were collected from video review and analyzed in \'CPR segments\' (periods of CPR by individual providers). Ventilation rate (breaths per minute, bpm) was calculated for each segment; hyperventilation was defined as >12 bpm according to 2015 American Heart Association guidelines. Univariate analysis between airway type was done by χ2 testing. Multivariate regression was used to determine the association between the presence of AA with hyperventilation while controlling for within-patient covariance.
779 CPR segments from 94 CPR event were analyzed. The mean ventilation rate per CPR segment across all events was 22 bpm (±16 bpm)). Mean ventilation rates were higher with AA, either ETT (24 ± 17 bpm) or SGA (34 ± 19 bpm), than with NA (17 ± 14, p < 0.001). Hyperventilation occurred more often with AA in place (ETT: 68%; SGA: 96%; NA: 43%; p < 0.001). The presence of AA was independently associated with hyperventilation (AOR 9.3, 95% CI 4.3-20.1).
During pediatric CPR, hyperventilation occurs more often with an AA in place than during CPR with NA. Future research should focus on respiratory physiology during pediatric CPR to determine optimal ventilation rate(s) during pediatric cardiac arrest.
Prospective observational study, January 2017 to June 2020. Patients ≤18 years receiving CC for ≥2 minutes were enrolled. Ventilation rate and type of airway (advanced airway (AA), either endotracheal tube (ETT) or supraglottic airway (SGA); or natural airway (NA)) were collected from video review and analyzed in \'CPR segments\' (periods of CPR by individual providers). Ventilation rate (breaths per minute, bpm) was calculated for each segment; hyperventilation was defined as >12 bpm according to 2015 American Heart Association guidelines. Univariate analysis between airway type was done by χ2 testing. Multivariate regression was used to determine the association between the presence of AA with hyperventilation while controlling for within-patient covariance.
779 CPR segments from 94 CPR event were analyzed. The mean ventilation rate per CPR segment across all events was 22 bpm (±16 bpm)). Mean ventilation rates were higher with AA, either ETT (24 ± 17 bpm) or SGA (34 ± 19 bpm), than with NA (17 ± 14, p < 0.001). Hyperventilation occurred more often with AA in place (ETT: 68%; SGA: 96%; NA: 43%; p < 0.001). The presence of AA was independently associated with hyperventilation (AOR 9.3, 95% CI 4.3-20.1).
During pediatric CPR, hyperventilation occurs more often with an AA in place than during CPR with NA. Future research should focus on respiratory physiology during pediatric CPR to determine optimal ventilation rate(s) during pediatric cardiac arrest.
摘要：
目的：确定小儿心肺复苏（CPR）过程中出现高级气道与通气率之间的关系。
方法：前瞻性观察研究，2017年1月至2020年6月。纳入≤18年接受CC≥2分钟的患者。通气率和气道类型(晚期气道(AA)，从视频回顾中收集气管内导管(ETT)或声门上气道(SGA)或自然气道(NA),并在“CPR”部分(个别提供者的CPR期间)进行分析.通气率（每分钟呼吸次数，计算每个节段的bpm）；根据2015年美国心脏协会指南，过度换气被定义为>12bpm。通过X2测试进行气道类型之间的单变量分析。多变量回归用于确定AA的存在与过度换气之间的关联，同时控制患者内部协方差。
结果：分析了来自94例CPR事件的779例CPR片段。所有事件中每个CPR段的平均通气率为22bpm（±16bpm））。AA的平均通气率较高，ETT（24±17bpm）或SGA（34±19bpm），比NA（17±14，p<0.001）。换气过度更多发生在AA的地方（ETT：68％;SGA：96％;NA：43％;p<0.001）。AA的存在与过度换气独立相关（AOR9.3，95％CI4.3-20.1）。
结论：在小儿CPR期间，在有AA的情况下发生过度通气的频率高于在有NA的CPR期间。未来的研究应集中在小儿CPR期间的呼吸生理学，以确定小儿心脏骤停期间的最佳通气率。
方法：前瞻性观察研究，2017年1月至2020年6月。纳入≤18年接受CC≥2分钟的患者。通气率和气道类型(晚期气道(AA)，从视频回顾中收集气管内导管(ETT)或声门上气道(SGA)或自然气道(NA),并在“CPR”部分(个别提供者的CPR期间)进行分析.通气率（每分钟呼吸次数，计算每个节段的bpm）；根据2015年美国心脏协会指南，过度换气被定义为>12bpm。通过X2测试进行气道类型之间的单变量分析。多变量回归用于确定AA的存在与过度换气之间的关联，同时控制患者内部协方差。
结果：分析了来自94例CPR事件的779例CPR片段。所有事件中每个CPR段的平均通气率为22bpm（±16bpm））。AA的平均通气率较高，ETT（24±17bpm）或SGA（34±19bpm），比NA（17±14，p<0.001）。换气过度更多发生在AA的地方（ETT：68％;SGA：96％;NA：43％;p<0.001）。AA的存在与过度换气独立相关（AOR9.3，95％CI4.3-20.1）。
结论：在小儿CPR期间，在有AA的情况下发生过度通气的频率高于在有NA的CPR期间。未来的研究应集中在小儿CPR期间的呼吸生理学，以确定小儿心脏骤停期间的最佳通气率。
