Acute cardiac care & resuscitation
Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023
Main finding · 30-day mortalityResult — go to the resultAdjusted relative risk 1.38 95% CI 1.14–1.67Authors' conclusion
In pediatric drowning OHCA, CO-CPR was associated with worse survival and neurological outcomes than RB-CPR. These findings underscore the necessity for rescue breathing and the importance of ventilation-focused bystander CPR training in pediatric and drowning-related scenarios.
Study context
- Population
- Pediatric out-of-hospital cardiac arrest (OHCA) patients (≤17 years old) whose arrests were caused by drowning and received bystander CPR from laypersons
- Participants
- 740 eligible patients
- Exposure
- Compression-only CPR (CO-CPR) compared with rescue-breathing CPR (RB-CPR)
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsAll-Japan Utstein Registry (2012-2023), multivariable Poisson regression
- All-Japan Utstein Registry (2012-2023)
- Multivariable Poisson regression
Main finding
As reported in the abstract
Adjusted relative risk
1.38
95% CI 1.14–1.67
CO-CPRvs RB-CPR
aRR 1.38 (95% CI 1.14–1.67)
Observational data: associations, not effects.
Secondary outcomes
Bystander CPR type
Bystander CPR type
- The proportion of RB-CPR declined over the study period
Prehospital absence of return of spontaneous circulation (ROSC) and 30-day unfavorable neurological survival (secondary)
- CO-CPR associated with higher prehospital absence of ROSC and worse neurological outcomes compared with RB-CPR
By witnessed status (subgroup)
- Adverse association of CO-CPR most pronounced in unwitnessed arrests
Original publication
Decline in rescue breathing and its impact on outcomes in pediatric out-of-hospital cardiac arrest due to drowning: a nationwide study, 2012–2023. Resuscitation. Published 10 March 2026. doi:10.
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