Duration of Prehospital Cardiopulmonary Resuscitation and Favorable Neurological Outcomes for Pediatric Out-of-Hospital Cardiac Arrests: A Nationwide, Population-Based Cohort Study
Authors' conclusion
Prehospital EMS-initiated CPR duration for pediatric OHCAs was independently and inversely associated with 30-day favorable outcomes. The duration of prehospital EMS-initiated CPR, beyond which the chance for 30-day favorable outcomes diminished to <1%, was 42 minutes. However, the CPR duration to achieve this proportion of outcomes differed based on initial rhythm.
Study context
- Population
- Pediatric OHCA patients (<18 years), nationwide Japanese database, 2005–2012
- Participants
- 12,877 patients
- Exposure
- Duration of prehospital emergency medical services (EMS)-initiated cardiopulmonary resuscitation (CPR)
- Outcome
- 30-day survival and 30-day survival with favorable neurological outcome (CPC 1-2)
- Follow-up
- 30 days
Methodological detailsnationwide registry
- Nationwide registry
Main finding
As reported in the abstract
Per 1-minute increment, as printed
- 30-day survival (all patients)
- 9.1% (n=1167)
- 30-day CPC 1-2 (all patients)
- 2.5% (n=325)
- CPR duration beyond which chance of 30-day survival and of 30-day CPC 1-2 fell to <1%
- 42 minutes
Observational data: associations, not effects.
Further findings
CPR duration beyond which chance of 30-day CPC 1-2 <1%, by initial rhythm (subgroup)
Minutes
- Shockable rhythms
- 39
- Pulseless electric activity
- 42
- Asystole
- 46
Prehospital CPR duration from call receipt beyond which chance of favorable outcome <1%, bystander-initiated CPR (subgroup)
- Bystander-initiated CPR
- 46 minutes
Original publication
Summarised from the published abstract; every number is checked against it