Abstract 300: Implementation of the Combination of CAB Algorithm and CC-Only CPR Does Not Worsen the Outcomes of Paediatric Out-of-Hospital Cardiac Arrests: Nation Wide Population Based Study
Backgrounds: Although cardiac arrest with respiratory origin is dominant in children, CAB algorithm was implemented in guidelines 2010 on top of chest compression only cardiopulmonary resuscitation (CC-only CPR) to let citizen BLS be simple. There is no evaluation done on paediatric outcomes after these changes.
Methods: In a nationwide out-of-hospital cardiac arrest registration from 2005 to 2011, we enrolled 13,159 children aged less than 18 years old. Data collected including the date of the event, age of victim, type of CPR, time from collapse to initiate CPR, and several outcomes (return of spontaneous circulation; ROSC, one-month survival, neurological outcome). Favorable outcome was defined as cerebral performance category 1 or 2. Data was analyzed in chronological fashion in each year.
Results: Resuscitation was attempted on 12,594 children during this period. In each year, total cases were 1,799 per year in average (range of 1,619-2,074), ROSC was achieved in 114 cases (6.3[5.8-7.7]%), one-month survival in 72 (4.0[3.2-5.2]%), and good neurological outcome in 46 (2.6[2.0-3.1]%). In witnessed victims, total cases were 465 per year in average (range of 412-531), ROSC was achieved in 59 (13[11-15]%), one-month survival in 41 (8.8[6.5-12]%), and good neurological outcome in 30 (6.4[4.4-7.9]%). Bystander CPR was done in 234 (50%) cases per year and no trend of chronological change, however, CC-only CPR tend to be done more recently (27% in 2005 vs. 62% in 2011). With these backgrounds, there was no significant improvement of time from collapse to start CPR, but no deterioration of outcomes either, so far. Analysis after excluding infants showed same trends, and one month survival has a tendency to get better (p=0.08).
Conclusions: The combination of CAB algorithm and CC-only CPR did not worsen the outcomes of paediatric out-of-hospital cardiac arrest based on the nation wide population based study. Enhancement of bystander CPR and further encouragement of shortening the time to initiate CPR is warranted.
- © 2013 by American Heart Association, Inc.