Every year in the United States, more than 5,000 children experience
out-of-hospital cardiac arrest (OHCA) and the outcome is generally
poor, with a mortality rate greater than 90%. The American Heart
Association (AHA) recommends conventional cardiopulmonary resuscitation (CPR) for pediatric cardiac
However if the bystander is unable or reluctant to perform
rescue breathing, the AHA recommends compression-only CPR (COR), noting
that delivering COR is better than no CPR.
‘Receiving cardiopulmonary resuscitation (CPR) from a bystander - compared with not - was associated with better overall and neurologically favorable survival for children who had out-of-hospital cardiac arrest.’
Receiving cardiopulmonary resuscitation (CPR) from a bystander -
compared with not - was associated with better overall and
neurologically favorable survival for children and adolescents who had
out-of-hospital cardiac arrest, revealed an article published online
by JAMA Pediatrics
. The study is being presented at the American Heart Association's Scientific Sessions 2016.
Maryam Y. Naim of Children's Hospital of Philadelphia, and
coauthors analyzed data from the Cardiac Arrest Registry to Enhance
Survival for OHCAs in children younger than 18 from January 2013 through
The study included 3,900 children with OHCA, of whom 2,317 (59.4%) were infants, 2,346 (60.2%) were female and 3,595 (92.2%) had nonshockable heart rhythms. Cardiac arrests that occur in
infants are most likely secondary to sudden infant death syndrome,
according to the report.
The authors report-
- CPR from bystanders was performed on 1,814 children (46.5%).
- Overall survival was 11.3% and neurologically favorable survival was 9.1%.
- CPR from a bystander was more common for white children compared with black and Hispanic children.
- CPR from a bystander was associated with better odds
of overall survival and neurologically favorable survival compared with
- Conventional CPR and compression-only CPR were
provided in a similar number of cases; conventional CPR was associated
with improved outcomes compared with compression-only CPR; among
infants, conventional CPR from a bystander was associated with improved
outcomes while compression-only CPR had outcomes similar to no CPR from a
Limitations to the study are that the data are observational and causality cannot be established.
"Bystander CPR is associated with improved outcomes in children with
OHCA. Conventional BCPR [bystander CPR] is associated with improved
outcomes compared with COR [compression-only CPR] and, among infants,
there was no benefit of BCPR unless ventilations were provided. Efforts
to improve the provision of CPR in minority communities and increasing
the use of conventional BCPR may improve outcomes for children with
OHCA," the study concludes.