Abstract
Aims Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry. We included paediatric OHCA patients (aged between 1 and 17 years) who received at least one dose of epinephrine. The primary outcome was 30-day survival. A total of 225 patients were included in the final cohort. Among the 225 patients, 23 (10.2%) survived 30 days after OHCA. The median time from emergency call to first epinephrine administration was 26 min [interquartile range, 20-32; range, 9-128; mean (standard deviation), 28.7 (15.5) min]. Longer time to epinephrine administration was associated with decreased chance of survival: 50.0, 41.2, 13.0, 11.6, 3.9, and 3.1%, respectively, when time to epinephrine was treated as a categorical variable categorized into <-10, 11-15, 16-20, 21-25, 26-30, or > 30 min (P for trend <0.0001), and adjusted odds ratio 0.90 (95% confidence interval 0.82-0.96, P = 0.0011) when time to epinephrine was treated as a linear and continuous variable in a multivariable logistic regression model. Similar trends were observed for prehospital return of spontaneous circulation (P = 0.0032) and neurologically favourable survival (P = 0.0014). Conclusions Among paediatric OHCA patients, delayed administration of epinephrine was associated with a decreased chance of favourable outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 144-151 |
| Number of pages | 8 |
| Journal | European Heart Journal - Cardiovascular Pharmacotherapy |
| Volume | 4 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2018 Jul 1 |
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Keywords
- Cardiopulmonary resuscitation
- Children
- Epidemiology
- Out-of-hospital cardiac arrest
- Paediatrics
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Pharmacology (medical)
Cite this
Time to epinephrine and survival after paediatric out-of-hospital cardiac arrest. / Fukuda, Tatsuma; Kondo, Yutaka; Hayashida, Kei; Sekiguchi, Hiroshi; Kukita, Ichiro.
In: European Heart Journal - Cardiovascular Pharmacotherapy, Vol. 4, No. 3, 01.07.2018, p. 144-151.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Time to epinephrine and survival after paediatric out-of-hospital cardiac arrest
AU - Fukuda, Tatsuma
AU - Kondo, Yutaka
AU - Hayashida, Kei
AU - Sekiguchi, Hiroshi
AU - Kukita, Ichiro
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Aims Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry. We included paediatric OHCA patients (aged between 1 and 17 years) who received at least one dose of epinephrine. The primary outcome was 30-day survival. A total of 225 patients were included in the final cohort. Among the 225 patients, 23 (10.2%) survived 30 days after OHCA. The median time from emergency call to first epinephrine administration was 26 min [interquartile range, 20-32; range, 9-128; mean (standard deviation), 28.7 (15.5) min]. Longer time to epinephrine administration was associated with decreased chance of survival: 50.0, 41.2, 13.0, 11.6, 3.9, and 3.1%, respectively, when time to epinephrine was treated as a categorical variable categorized into <-10, 11-15, 16-20, 21-25, 26-30, or > 30 min (P for trend <0.0001), and adjusted odds ratio 0.90 (95% confidence interval 0.82-0.96, P = 0.0011) when time to epinephrine was treated as a linear and continuous variable in a multivariable logistic regression model. Similar trends were observed for prehospital return of spontaneous circulation (P = 0.0032) and neurologically favourable survival (P = 0.0014). Conclusions Among paediatric OHCA patients, delayed administration of epinephrine was associated with a decreased chance of favourable outcomes.
AB - Aims Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry. We included paediatric OHCA patients (aged between 1 and 17 years) who received at least one dose of epinephrine. The primary outcome was 30-day survival. A total of 225 patients were included in the final cohort. Among the 225 patients, 23 (10.2%) survived 30 days after OHCA. The median time from emergency call to first epinephrine administration was 26 min [interquartile range, 20-32; range, 9-128; mean (standard deviation), 28.7 (15.5) min]. Longer time to epinephrine administration was associated with decreased chance of survival: 50.0, 41.2, 13.0, 11.6, 3.9, and 3.1%, respectively, when time to epinephrine was treated as a categorical variable categorized into <-10, 11-15, 16-20, 21-25, 26-30, or > 30 min (P for trend <0.0001), and adjusted odds ratio 0.90 (95% confidence interval 0.82-0.96, P = 0.0011) when time to epinephrine was treated as a linear and continuous variable in a multivariable logistic regression model. Similar trends were observed for prehospital return of spontaneous circulation (P = 0.0032) and neurologically favourable survival (P = 0.0014). Conclusions Among paediatric OHCA patients, delayed administration of epinephrine was associated with a decreased chance of favourable outcomes.
KW - Cardiopulmonary resuscitation
KW - Children
KW - Epidemiology
KW - Out-of-hospital cardiac arrest
KW - Paediatrics
UR - http://www.scopus.com/inward/record.url?scp=85049346610&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049346610&partnerID=8YFLogxK
U2 - 10.1093/ehjcvp/pvx023
DO - 10.1093/ehjcvp/pvx023
M3 - Article
VL - 4
SP - 144
EP - 151
JO - European Heart Journal - Cardiovascular Pharmacotherapy
JF - European Heart Journal - Cardiovascular Pharmacotherapy
SN - 2055-6837
IS - 3
ER -