Early Cardiac Arrest Hemodynamics, End-Tidal Co 2, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)

Andrew R. Yates; Maryam Y. Naim; Ron W. Reeder; Tageldin Ahmed; Russell K. Banks; Michael J. Bell; Robert A. Berg; Robert Bishop; Matthew Bochkoris; Candice Burns; Joseph A. Carcillo; Todd C. Carpenter; J. Michael Dean; J. Wesley Diddle; Myke Federman; Richard Fernandez; Ericka L. Fink; Deborah Franzon; Aisha H. Frazier; Stuart H. Friess; Kathryn Graham; Mark Hall; David A. Hehir; Christopher M. Horvat; Leanna L. Huard; Tensing Maa; Arushi Manga; Patrick S. McQuillen; Ryan W. Morgan; Peter M. Mourani; Vinay M. Nadkarni; Daniel Notterman; Murray M. Pollack; Anil Sapru; Carleen Schneiter; Matthew P. Sharron; Neeraj Srivastava; Bradley Tilford; Shirley Viteri; David Wessel; Heather A. Wolfe; Justin Yeh; Athena F. Zuppa; Robert M. Sutton; Kathleen L. Meert

doi:10.1097/PCC.0000000000003423

Early Cardiac Arrest Hemodynamics, End-Tidal Co ₂, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)

Andrew R. Yates, Maryam Y. Naim, Ron W. Reeder, Tageldin Ahmed, Russell K. Banks, Michael J. Bell, Robert A. Berg, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph A. Carcillo, Todd C. Carpenter, J. Michael Dean, J. Wesley Diddle, Myke Federman, Richard Fernandez, Ericka L. Fink, Deborah Franzon, Aisha H. Frazier, Stuart H. FriessKathryn Graham, Mark Hall, David A. Hehir, Christopher M. Horvat, Leanna L. Huard, Tensing Maa, Arushi Manga, Patrick S. McQuillen, Ryan W. Morgan, Peter M. Mourani, Vinay M. Nadkarni, Daniel Notterman, Murray M. Pollack, Anil Sapru, Carleen Schneiter, Matthew P. Sharron, Neeraj Srivastava, Bradley Tilford, Shirley Viteri, David Wessel, Heather A. Wolfe, Justin Yeh, Athena F. Zuppa, Robert M. Sutton, Kathleen L. Meert

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

OBJECTIVES: Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal Co₂(ETco₂) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients. DESIGN: Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497). SETTING: Eighteen ICUs participated in ICU-RESUS. PATIENTS: There were 97 ECPR patients with hemodynamic waveforms during cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Overall, 71 of 97 patients (73%) were younger than 1 year old, 82 of 97 (85%) had congenital heart disease, and 62 of 97 (64%) were postoperative cardiac surgical patients. Forty of 97 patients (41%) survived with favorable neurologic outcome. We failed to find differences in diastolic or systolic blood pressure, proportion achieving age-based target diastolic or systolic blood pressure, or chest compression rate during the initial 10 minutes of CPR between patients who survived with favorable neurologic outcome and those who did not. Thirty-five patients had ETco₂data; of 17 survivors with favorable neurologic outcome, four of 17 (24%) had an average ETco₂less than 10 mm Hg and two (12%) had a maximum ETco₂less than 10 mm Hg during the initial 10 minutes of resuscitation. CONCLUSIONS: We did not identify an association between early hemodynamics achieved by high-quality CPR and survival to hospital discharge with favorable neurologic outcome after pediatric ECPR. Candidates for ECPR with ETco₂less than 10 mm Hg may survive with favorable neurologic outcome.

Original language	English
Pages (from-to)	312-322
Number of pages	11
Journal	Pediatric Critical Care Medicine
Volume	25
Issue number	4
DOIs	https://doi.org/10.1097/PCC.0000000000003423
State	Published - Apr 1 2024

Keywords

cardiopulmonary resuscitation
extracorporeal cardiopulmonary resuscitation
extracorporeal membrane oxygenation
hemodynamics

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10.1097/PCC.0000000000003423

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Yates, A. R., Naim, M. Y., Reeder, R. W., Ahmed, T., Banks, R. K., Bell, M. J., Berg, R. A., Bishop, R., Bochkoris, M., Burns, C., Carcillo, J. A., Carpenter, T. C., Dean, J. M., Diddle, J. W., Federman, M., Fernandez, R., Fink, E. L., Franzon, D., Frazier, A. H., ... Meert, K. L. (2024). Early Cardiac Arrest Hemodynamics, End-Tidal Co ₂, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021). Pediatric Critical Care Medicine, 25(4), 312-322. https://doi.org/10.1097/PCC.0000000000003423

@article{058c3b2525014400ade9be5c35f8d61a,

title = "Early Cardiac Arrest Hemodynamics, End-Tidal Co 2, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)",

abstract = "OBJECTIVES: Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal Co2(ETco2) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients. DESIGN: Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497). SETTING: Eighteen ICUs participated in ICU-RESUS. PATIENTS: There were 97 ECPR patients with hemodynamic waveforms during cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Overall, 71 of 97 patients (73%) were younger than 1 year old, 82 of 97 (85%) had congenital heart disease, and 62 of 97 (64%) were postoperative cardiac surgical patients. Forty of 97 patients (41%) survived with favorable neurologic outcome. We failed to find differences in diastolic or systolic blood pressure, proportion achieving age-based target diastolic or systolic blood pressure, or chest compression rate during the initial 10 minutes of CPR between patients who survived with favorable neurologic outcome and those who did not. Thirty-five patients had ETco2data; of 17 survivors with favorable neurologic outcome, four of 17 (24%) had an average ETco2less than 10 mm Hg and two (12%) had a maximum ETco2less than 10 mm Hg during the initial 10 minutes of resuscitation. CONCLUSIONS: We did not identify an association between early hemodynamics achieved by high-quality CPR and survival to hospital discharge with favorable neurologic outcome after pediatric ECPR. Candidates for ECPR with ETco2less than 10 mm Hg may survive with favorable neurologic outcome.",

keywords = "cardiopulmonary resuscitation, extracorporeal cardiopulmonary resuscitation, extracorporeal membrane oxygenation, hemodynamics",

author = "Yates, {Andrew R.} and Naim, {Maryam Y.} and Reeder, {Ron W.} and Tageldin Ahmed and Banks, {Russell K.} and Bell, {Michael J.} and Berg, {Robert A.} and Robert Bishop and Matthew Bochkoris and Candice Burns and Carcillo, {Joseph A.} and Carpenter, {Todd C.} and Dean, {J. Michael} and Diddle, {J. Wesley} and Myke Federman and Richard Fernandez and Fink, {Ericka L.} and Deborah Franzon and Frazier, {Aisha H.} and Friess, {Stuart H.} and Kathryn Graham and Mark Hall and Hehir, {David A.} and Horvat, {Christopher M.} and Huard, {Leanna L.} and Tensing Maa and Arushi Manga and McQuillen, {Patrick S.} and Morgan, {Ryan W.} and Mourani, {Peter M.} and Nadkarni, {Vinay M.} and Daniel Notterman and Pollack, {Murray M.} and Anil Sapru and Carleen Schneiter and Sharron, {Matthew P.} and Neeraj Srivastava and Bradley Tilford and Shirley Viteri and David Wessel and Wolfe, {Heather A.} and Justin Yeh and Zuppa, {Athena F.} and Sutton, {Robert M.} and Meert, {Kathleen L.}",

year = "2024",

month = apr,

day = "1",

doi = "10.1097/PCC.0000000000003423",

language = "English",

volume = "25",

pages = "312--322",

journal = "Pediatric Critical Care Medicine",

issn = "1529-7535",

number = "4",

}

Yates, AR, Naim, MY, Reeder, RW, Ahmed, T, Banks, RK, Bell, MJ, Berg, RA, Bishop, R, Bochkoris, M, Burns, C, Carcillo, JA, Carpenter, TC, Dean, JM, Diddle, JW, Federman, M, Fernandez, R, Fink, EL, Franzon, D, Frazier, AH, Friess, SH, Graham, K, Hall, M, Hehir, DA, Horvat, CM, Huard, LL, Maa, T, Manga, A, McQuillen, PS, Morgan, RW, Mourani, PM, Nadkarni, VM, Notterman, D, Pollack, MM, Sapru, A, Schneiter, C, Sharron, MP, Srivastava, N, Tilford, B, Viteri, S, Wessel, D, Wolfe, HA, Yeh, J, Zuppa, AF, Sutton, RM & Meert, KL 2024, 'Early Cardiac Arrest Hemodynamics, End-Tidal Co ₂, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)', Pediatric Critical Care Medicine, vol. 25, no. 4, pp. 312-322. https://doi.org/10.1097/PCC.0000000000003423

Early Cardiac Arrest Hemodynamics, End-Tidal Co ₂, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021). / Yates, Andrew R.; Naim, Maryam Y.; Reeder, Ron W. et al.
In: Pediatric Critical Care Medicine, Vol. 25, No. 4, 01.04.2024, p. 312-322.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Early Cardiac Arrest Hemodynamics, End-Tidal Co 2, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation

T2 - Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)

AU - Yates, Andrew R.

AU - Naim, Maryam Y.

AU - Reeder, Ron W.

AU - Ahmed, Tageldin

AU - Banks, Russell K.

AU - Bell, Michael J.

AU - Berg, Robert A.

AU - Bishop, Robert

AU - Bochkoris, Matthew

AU - Burns, Candice

AU - Carcillo, Joseph A.

AU - Carpenter, Todd C.

AU - Dean, J. Michael

AU - Diddle, J. Wesley

AU - Federman, Myke

AU - Fernandez, Richard

AU - Fink, Ericka L.

AU - Franzon, Deborah

AU - Frazier, Aisha H.

AU - Friess, Stuart H.

AU - Graham, Kathryn

AU - Hall, Mark

AU - Hehir, David A.

AU - Horvat, Christopher M.

AU - Huard, Leanna L.

AU - Maa, Tensing

AU - Manga, Arushi

AU - McQuillen, Patrick S.

AU - Morgan, Ryan W.

AU - Mourani, Peter M.

AU - Nadkarni, Vinay M.

AU - Notterman, Daniel

AU - Pollack, Murray M.

AU - Sapru, Anil

AU - Schneiter, Carleen

AU - Sharron, Matthew P.

AU - Srivastava, Neeraj

AU - Tilford, Bradley

AU - Viteri, Shirley

AU - Wessel, David

AU - Wolfe, Heather A.

AU - Yeh, Justin

AU - Zuppa, Athena F.

AU - Sutton, Robert M.

AU - Meert, Kathleen L.

PY - 2024/4/1

Y1 - 2024/4/1

N2 - OBJECTIVES: Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal Co2(ETco2) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients. DESIGN: Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497). SETTING: Eighteen ICUs participated in ICU-RESUS. PATIENTS: There were 97 ECPR patients with hemodynamic waveforms during cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Overall, 71 of 97 patients (73%) were younger than 1 year old, 82 of 97 (85%) had congenital heart disease, and 62 of 97 (64%) were postoperative cardiac surgical patients. Forty of 97 patients (41%) survived with favorable neurologic outcome. We failed to find differences in diastolic or systolic blood pressure, proportion achieving age-based target diastolic or systolic blood pressure, or chest compression rate during the initial 10 minutes of CPR between patients who survived with favorable neurologic outcome and those who did not. Thirty-five patients had ETco2data; of 17 survivors with favorable neurologic outcome, four of 17 (24%) had an average ETco2less than 10 mm Hg and two (12%) had a maximum ETco2less than 10 mm Hg during the initial 10 minutes of resuscitation. CONCLUSIONS: We did not identify an association between early hemodynamics achieved by high-quality CPR and survival to hospital discharge with favorable neurologic outcome after pediatric ECPR. Candidates for ECPR with ETco2less than 10 mm Hg may survive with favorable neurologic outcome.

AB - OBJECTIVES: Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal Co2(ETco2) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients. DESIGN: Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497). SETTING: Eighteen ICUs participated in ICU-RESUS. PATIENTS: There were 97 ECPR patients with hemodynamic waveforms during cardiopulmonary resuscitation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Overall, 71 of 97 patients (73%) were younger than 1 year old, 82 of 97 (85%) had congenital heart disease, and 62 of 97 (64%) were postoperative cardiac surgical patients. Forty of 97 patients (41%) survived with favorable neurologic outcome. We failed to find differences in diastolic or systolic blood pressure, proportion achieving age-based target diastolic or systolic blood pressure, or chest compression rate during the initial 10 minutes of CPR between patients who survived with favorable neurologic outcome and those who did not. Thirty-five patients had ETco2data; of 17 survivors with favorable neurologic outcome, four of 17 (24%) had an average ETco2less than 10 mm Hg and two (12%) had a maximum ETco2less than 10 mm Hg during the initial 10 minutes of resuscitation. CONCLUSIONS: We did not identify an association between early hemodynamics achieved by high-quality CPR and survival to hospital discharge with favorable neurologic outcome after pediatric ECPR. Candidates for ECPR with ETco2less than 10 mm Hg may survive with favorable neurologic outcome.

KW - cardiopulmonary resuscitation

KW - extracorporeal cardiopulmonary resuscitation

KW - extracorporeal membrane oxygenation

KW - hemodynamics

UR - http://www.scopus.com/inward/record.url?scp=85190175313&partnerID=8YFLogxK

U2 - 10.1097/PCC.0000000000003423

DO - 10.1097/PCC.0000000000003423

M3 - Article

C2 - 38088765

AN - SCOPUS:85190175313

SN - 1529-7535

VL - 25

SP - 312

EP - 322

JO - Pediatric Critical Care Medicine

JF - Pediatric Critical Care Medicine

IS - 4

ER -

Early Cardiac Arrest Hemodynamics, End-Tidal Co ₂, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016-2021)

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