Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest
Background: Respiratory care, including advanced airway management (AAM), is an important part of pediatric resuscitation. This study aimed to determine whether time to AAM is associated with outcomes after out-of-hospital cardiac arrest (OHCA) in children. Methods: This was a nationwide population-...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520422000601 |
| _version_ | 1828379353625395200 |
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| author | Naoko Ohashi-Fukuda Tatsuma Fukuda Kent Doi |
| author_facet | Naoko Ohashi-Fukuda Tatsuma Fukuda Kent Doi |
| author_sort | Naoko Ohashi-Fukuda |
| collection | DOAJ |
| description | Background: Respiratory care, including advanced airway management (AAM), is an important part of pediatric resuscitation. This study aimed to determine whether time to AAM is associated with outcomes after out-of-hospital cardiac arrest (OHCA) in children. Methods: This was a nationwide population-based observational study using the Japanese government-led registry of OHCA patients. Children (aged 1–17 years) who experienced OHCA and received AAM by emergency medical service (EMS) personnel in the prehospital setting from 2014 to 2019 were included. Multivariable logistic regression models were used to assess the associations between time to AAM (defined as time in minutes from emergency call to the first successful AAM) and outcomes after OHCA. The primary outcome was one-month overall survival. The secondary outcomes were prehospital return of spontaneous circulation (ROSC) and one-month neurologically favorable survival. Results: A total of 761 patients (mean [SD] age, 12.7 [4.8] years) were included. The mean time to AAM was 18.9 min (SD, 7.9). Overall, 77 (10.1%) patients survived one month after OHCA. After adjusting for potential confounders, longer time to AAM was significantly associated with a decreased chance of one-month survival (multivariable adjusted OR per minute delay, 0.93 [95% CI, 0.89–0.97]; P = 0.001). Similar association was observed for prehospital ROSC (adjusted OR, 0.94 [95% CI, 0.90–0.99]; P = 0.01) and neurologically favorable survival (adjusted OR, 0.83 [95% CI, 0.72–0.95]; P = 0.006). This association between time to AAM and survival was consistent across a variety of sensitivity and subgroup analyses. Conclusions: Among pediatric OHCA patients, delayed AAM was associated with a decreased chance of survival, although the influence of resuscitation time bias might remain. |
| first_indexed | 2024-12-10T03:39:14Z |
| format | Article |
| id | doaj.art-1de463b2c4fd4b30b8585300fa008cd2 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-12-10T03:39:14Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-1de463b2c4fd4b30b8585300fa008cd22022-12-22T02:03:37ZengElsevierResuscitation Plus2666-52042022-09-0111100260Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrestNaoko Ohashi-Fukuda0Tatsuma Fukuda1Kent Doi2Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, Toranomon Hospital, Tokyo, Japan; Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan; Corresponding author at: Department of Emergency and Critical Care Medicine, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan.Department of Emergency and Critical Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanBackground: Respiratory care, including advanced airway management (AAM), is an important part of pediatric resuscitation. This study aimed to determine whether time to AAM is associated with outcomes after out-of-hospital cardiac arrest (OHCA) in children. Methods: This was a nationwide population-based observational study using the Japanese government-led registry of OHCA patients. Children (aged 1–17 years) who experienced OHCA and received AAM by emergency medical service (EMS) personnel in the prehospital setting from 2014 to 2019 were included. Multivariable logistic regression models were used to assess the associations between time to AAM (defined as time in minutes from emergency call to the first successful AAM) and outcomes after OHCA. The primary outcome was one-month overall survival. The secondary outcomes were prehospital return of spontaneous circulation (ROSC) and one-month neurologically favorable survival. Results: A total of 761 patients (mean [SD] age, 12.7 [4.8] years) were included. The mean time to AAM was 18.9 min (SD, 7.9). Overall, 77 (10.1%) patients survived one month after OHCA. After adjusting for potential confounders, longer time to AAM was significantly associated with a decreased chance of one-month survival (multivariable adjusted OR per minute delay, 0.93 [95% CI, 0.89–0.97]; P = 0.001). Similar association was observed for prehospital ROSC (adjusted OR, 0.94 [95% CI, 0.90–0.99]; P = 0.01) and neurologically favorable survival (adjusted OR, 0.83 [95% CI, 0.72–0.95]; P = 0.006). This association between time to AAM and survival was consistent across a variety of sensitivity and subgroup analyses. Conclusions: Among pediatric OHCA patients, delayed AAM was associated with a decreased chance of survival, although the influence of resuscitation time bias might remain.http://www.sciencedirect.com/science/article/pii/S2666520422000601Out-of-hospital cardiac arrestCardiopulmonary resuscitationAdvanced airway managementChildrenPediatrics |
| spellingShingle | Naoko Ohashi-Fukuda Tatsuma Fukuda Kent Doi Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest Resuscitation Plus Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Advanced airway management Children Pediatrics |
| title | Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest |
| title_full | Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest |
| title_fullStr | Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest |
| title_full_unstemmed | Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest |
| title_short | Association between time to advanced airway management and survival during pediatric out-of-hospital cardiac arrest |
| title_sort | association between time to advanced airway management and survival during pediatric out of hospital cardiac arrest |
| topic | Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Advanced airway management Children Pediatrics |
| url | http://www.sciencedirect.com/science/article/pii/S2666520422000601 |
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