Abstract 15807: Comparison of Conventional and Compression Only Bystander CPR Following Pediatric Out of Hospital Cardiac Arrest in the United States: A Study From the Cardiac Arrest Registry to Enhance Survival (CARES)
Introduction: Bystander compression only CPR (Co-CPR) is as effective as conventional CPR in adults with out of hospital cardiac arrest (OHCA). There are few data on Co-CPR in children.
Hypothesis: We aimed to characterize bystander Co-CPR in pediatric OHCA and test the hypothesis that conventional CPR would be associated with improved overall survival and neurologically favorable survival at hospital discharge compared to Co-CPR from a large cardiac arrest registry in the United States.
Methods: We conducted an analysis of the Cardiac Arrest Registry to Enhance Survival database. Inclusion criteria were age ≤ 18 years of age and non-traumatic OHCA from January 1, 2013 through December 31, 2015. Neurologically favorable survival was defined as a Cerebral Performance Category Scale of 1 or 2.
Results: A total of 3972 cardiac arrests were evaluated of which 1855 received bystander CPR and type of CPR data were available for 1458 arrests (79%). For those events where the type of CPR data was available, 49% (n=708) received conventional CPR, 50% (n=731) received Co-CPR, and 1% (n=19) received ventilation only CPR. Infants were more likely to receive conventional CPR and children > 1 to 18 years were more likely to receive Co-CPR (53% vs. 55%, p=0.0033). Compared to white children (49%), Hispanic children (64%) and black children (56%) were more likely to receive Co-CPR compared to conventional CPR (p<0.0001). There was no difference in the type of bystander CPR in gender, witnessed arrest status, arrest etiology, arrest location, arrest rhythm, and AED use. Overall survival was 17% for conventional CPR and 14% for Co-CPR (p=0.28). On subgroup analysis conventional CPR was associated with improved overall survival in infants and black children compared to Co-CPR. On multivariable analysis conventional CPR was independently associated with overall survival (OR 1.60, 95% CI 1.14-2.24) and neurologically favorable survival (OR 1.50, 95% CI 1.03-2.16) compared to Co-CPR.
Conclusions: In this study of pediatric OHCA bystander Co-CPR was provided as often frequently as conventional CPR. A racial disparity exists in the provision of conventional CPR. Conventional CPR was associated with improved overall survival and favorable neurological outcome compared to Co-CPR.
Author Disclosures: M.Y. Naim: None. R.V. Burke: None. B.F. McNally: None. L. Song: None. R.A. Berg: None. V.M. Nadkarni: None. K. Vellano: None. D. Markenson: None. R.N. Bradley: None. J.W. Rossano: None.
- © 2016 by American Heart Association, Inc.