High dose of epinephrine does not improve ...
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Article dans une revue scientifique: Article original
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Title :
High dose of epinephrine does not improve survival of children with out-of-hospital cardiac arrest: Results from the French National Cardiac Arrest Registry.
Author(s) :
Recher, Morgan [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Canon, Valentine [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
LOCKHART, Marguerite [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lafrance, Martin [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Hubert, Hervé [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Leteurtre, Stephane [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Canon, Valentine [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
LOCKHART, Marguerite [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Lafrance, Martin [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Hubert, Hervé [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Leteurtre, Stephane [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Journal title :
Frontiers in Pediatrics
Abbreviated title :
Front Pediatr
Volume number :
10
Pages :
978742
Publication date :
2022-10-27
ISSN :
2296-2360
English keyword(s) :
out-of-hospital cardiac arrest
cardiopulmonary resuscitation
epinephrine
guidelines
children
cardiopulmonary resuscitation
epinephrine
guidelines
children
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Objectives: The pediatric resuscitation guidelines recommend the use of 0. 01 mg kg−1 epinephrine during a cardiac arrest; an epinephrine dose higher than that is not recommended. The first aim of this study was to determine ...
Show more >Objectives: The pediatric resuscitation guidelines recommend the use of 0. 01 mg kg−1 epinephrine during a cardiac arrest; an epinephrine dose higher than that is not recommended. The first aim of this study was to determine the administration rate of high epinephrine dose during pediatric out-of-hospital cardiac arrest. The second aim was to compare the survival status in patients who received high or standard doses of epinephrine. Methods: This was a multicenter comparative post-hoc study conducted between January 2011 and July 2021 based on the French National Cardiac Arrest Registry data. All prepubescent (boys < 12 years old, girls < 10 years old) victims of an out-of-hospital cardiac arrest were included. To compare survival status and control bias, patients who received a high epinephrine dose were matched with those who received a standard epinephrine dose using propensity score matching. Results: The analysis included 755 patients; 400 (53%) received a high dose and 355 (47%) received a standard dose of epinephrine. The median dose (mg kg−1) per bolus was higher in the high-dose group than that in the standard dose group (0.04 vs. 0.01 mg kg−1, P < 0.001). Before matching, there was no between-group difference in the 30-day survival rate or survival status at hospital discharge. Matching yielded 288 pairs; there was no between-group difference in the 30-day survival rate or survival at hospital discharge (High dose, n = 5; standard dose, n = 12; Odds ratios: 2.40, 95% confidence interval: 0.85–6.81). Only 2 patients in the standard dose group had a good neurological outcome. Conclusion: More than 50% of the patients did not receive the recommended epinephrine dose during resuscitation. There was no association between patients receiving a high dose or standard dose of epinephrine with the 30-day survival or survival status at hospital discharge. Collaboration across multiple cardiac arrest registries is needed to study the application of pediatric guidelines.Show less >
Show more >Objectives: The pediatric resuscitation guidelines recommend the use of 0. 01 mg kg−1 epinephrine during a cardiac arrest; an epinephrine dose higher than that is not recommended. The first aim of this study was to determine the administration rate of high epinephrine dose during pediatric out-of-hospital cardiac arrest. The second aim was to compare the survival status in patients who received high or standard doses of epinephrine. Methods: This was a multicenter comparative post-hoc study conducted between January 2011 and July 2021 based on the French National Cardiac Arrest Registry data. All prepubescent (boys < 12 years old, girls < 10 years old) victims of an out-of-hospital cardiac arrest were included. To compare survival status and control bias, patients who received a high epinephrine dose were matched with those who received a standard epinephrine dose using propensity score matching. Results: The analysis included 755 patients; 400 (53%) received a high dose and 355 (47%) received a standard dose of epinephrine. The median dose (mg kg−1) per bolus was higher in the high-dose group than that in the standard dose group (0.04 vs. 0.01 mg kg−1, P < 0.001). Before matching, there was no between-group difference in the 30-day survival rate or survival status at hospital discharge. Matching yielded 288 pairs; there was no between-group difference in the 30-day survival rate or survival at hospital discharge (High dose, n = 5; standard dose, n = 12; Odds ratios: 2.40, 95% confidence interval: 0.85–6.81). Only 2 patients in the standard dose group had a good neurological outcome. Conclusion: More than 50% of the patients did not receive the recommended epinephrine dose during resuscitation. There was no association between patients receiving a high dose or standard dose of epinephrine with the 30-day survival or survival status at hospital discharge. Collaboration across multiple cardiac arrest registries is needed to study the application of pediatric guidelines.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
Université de Lille
CHU Lille
CHU Lille
Submission date :
2023-11-15T03:08:54Z
2024-01-16T12:27:01Z
2024-01-16T12:27:01Z
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