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 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.
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 none.
- 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 bystander.
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.