@article{a9fe88ff064c469591187ac4d070463a,
title = "Pediatric in-hospital CPR quality at night and on weekends",
abstract = "Introduction: Survival after in-hospital cardiac arrest (IHCA) has been reported to be worse for arrests at night or during weekends.This study aimed to determine whether measured cardiopulmonary resuscitation (CPR) quality metrics might explain this difference in outcomes. Methods: IHCA data was collected by the Pediatric Resuscitation Quality (pediRES-Q) collaborative for patients <18 years. Metrics of CPR quality [chest compression rate, depth and fraction] were measured using monitordefibrillator pads, and events were compared by time of day and day of week. Results: We evaluated 6915 sixty-second epochs of chest compression (CC) data from 239 subjects between October 2015 and March 2019, across 18 hospitals. There was no significant difference in CPR quality metrics during day (07:00–22:59) versus night (23:00–06:59), or weekdays (Monday 07:00 to Friday 22:59) versus weekends (Friday 23:00 to Monday 06:59).There was also no difference in rate of return of circulation. However, survival to hospital discharge was higher for arrests that occurred during the day (39.1%) vs. nights (22.4%, p = 0.015), as well as on weekdays (39.9%) vs. weekends (19.1%, p = 0.003). Conclusions: For pediatric IHCA where CC metrics were obtained, there was no significant difference in CPR quality metrics or rate of return of circulation by time of day or day of week. There was higher survival to hospital discharge when arrests occurred during the day (vs. nights), or on weekdays (vs. weekends), and this difference was not related to disparities in CC quality.",
keywords = "CPR, Cardiac arrest, Cardiopulmonary resuscitation, Chest compressions, Pediatric, Quality, Return of spontaneous circulation",
author = "Ivie Esangbedo and Priscilla Yu and Tia Raymond and Niles, {Dana E.} and Richard Hanna and Xuemei Zhang and Heather Wolfe and Heather Griffis and Vinay Nadkarni",
note = "Funding Information: Kamal Abulebda, Riley Hospital for Children, Indianapolis, IN, USA; Diane Atkins, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA; Utpal Bhalala, San Antonio Hospital for Children, San Antonio, TX, USA; Shilpa Balikai, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA; Marc Berg, Lucile Packard Children's Hospital, Palo Alto, CA, USA; Robert Berg, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Matthew S. Braga, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Corinne Buysse, Erasmus MC–Sophia Children{\textquoteright}s Hospital, Rotterdam, The Netherlands; Adam Cheng, Alberta Children's Hospital, Calgary, AB, Canada; Andrea Christoff, The Children{\textquoteright}s Hospital at Westmead, Westmead, Australia; Ashley Dalpaiz, Children{\textquoteright}s Healthcare of Atlanta, Atlanta, GA, USA; Allan DeCaen, Stollery Children's Hospital, Edmonton, AB, Canada; Jimena del Castillo, Hospital Maternoinfantil Gregorio Mara{\~n}{\'o}n, Madrid, Spain; Maya Dewan, Children{\textquoteright}s Hospital of Wisconsin, Milwaukee, WI, USA; Aaron Donoghue, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Jordan Duval-Arnould, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Juan Carlos Echeverry, Instituto Roosevelt, Bogota, Columbia; Ivie Esangbedo, UT Southwestern Medical Center, Dallas, TX, USA; Michael Flaherty, Massachusetts General Hospital, Boston, MA, USA; Stuart Friess, St. Louis Children{\textquoteright}s Hospital, St. Louis, MO, USA; Janie Garza, Children's Medical Center of Dallas, Dallas, TX, USA; Orsola Gawronski, Bambino Ges{\`u}, Rome, Italy; Elaine Gilfoyle, Alberta Children's Hospital, Calgary, AB, Canada; Heather Griffis, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Richard Hanna, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Sarah Haskell, University of Iowa Stead Family Children's Hospital, Iowa City, IA, USA; Jennifer Hayes, Children's Hospital of Orange County, Los Angeles, CA, USA; Kiran Hebbar, Children{\textquoteright}s Healthcare of Atlanta, Atlanta, GA, USA; Shu-Chien Huan, National Taiwan University Hospital, Taipei City, Taiwan; Betsy Hunt, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Takanari Ikeyama, Aichi Children's Health and Medical Center, Ohbu, Aichi Prefecture, Japan; Priti Jani, The University of Chicago Medicine Comer Children's Hospital, Chicago, IL, USA; Dean Jarvis, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; David Kessler, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY USA; Lynda Knight, Lucile Packard Children's Hospital, Palo Alto, CA, USA; Hiroshi Kurosawa, Kobe Children's Hospital, Hyōgo Prefecture, Japan; Luz Marina Mejia, Instituto Roosevelt, Bogota, Columbia; Dori-Ann Martin, Alberta Children's Hospital, Calgary, AB, Canada; Michael Meyer, Children{\textquoteright}s Hospital of Wisconsin, Milwaukee, WI, USA; Yee Hui Mok, KK Women{\textquoteright}s & Children{\textquoteright}s Hospital, Singapore; Ryan Morgan, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Vinay Nadkarni, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Sholeen Nett, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Dana E. Niles, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Gene Ong, KK Women{\textquoteright}s & Children{\textquoteright}s Hospital, Singapore; Jacqueline Ong, National University Children's Medical Institute, Singapore; Stephen Pfeiffer, Children{\textquoteright}s Hospital of Wisconsin, Milwaukee, WI, USA; Prakad Rajapreyar, Children{\textquoteright}s Hospital of Wisconsin, Milwaukee, WI, USA; Tia Raymond, Medical City Children's Hospital, Dallas, TX, USA; Joan Roberts, Seattle Children's Hospital, Seattle, WA, USA; Lindsay Ryerson, Stollery Children's Hospital, Edmonton, AB, Canada; Barney Scholefield, Birmingham Children{\textquoteright}s Hospital, Birmingham, UK; Anita Sen, NewYork-Presbyterian Morgan Stanley Children's Hospital, New York, NY, USA; Naoki Shimizu, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Sophie Skellett, Great Ormond Street Hospital, London, UK; Felice Su, Lucile Packard Children's Hospital, Palo Alto, CA, USA; Robert M. Sutton, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; Todd Sweberg, Cohen Children's Medical Center, New Hyde Park, NY, USA; Ken Tegtmeyer, Cincinnati Children{\textquoteright}s Hospital, Cincinnati, OH, USA; Javier Urbano Villaescusa, Hospital Maternoinfantil Gregorio Mara{\~n}{\'o}n, Madrid, Spain; Denise Welsby, Great Ormond Street Hospital, London, UK; Jesse Wenger, Seattle Children's Hospital, Seattle, WA, USA; Heather Wolfe, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA; En-Ting Wu, National Taiwan University Hospital, Taipei City, Taiwan; Andrea Yeo, National University Children's Medical Institute, Singapore; Priscilla Yu, UT Southwestern Medical Center, Dallas, TX; Xuemei Zhang, The Children{\textquoteright}s Hospital of Philadelphia, Philadelphia, PA, USA. Funding Information: We would like to thank the teams of clinicians and quality improvement/research staff that invested time, effort, and enthusiasm in this collaborative effort. We would like to thank Annemarie Silver, PhD, from ZOLL Medical for her valuable contributions and unique insights into pediatric chest compression metrics. The concept and development of the resuscitation clinical learning laboratory collaboration would not have been possible without the generous and unrestricted educational grant support of Laerdal Medical (2006-2013) and ZOLL Medical (2014-2019). Funding Information: Dana Niles, Heather Wolfe, and Vinay Nadkarni disclose that The Children{\textquoteright}s Hospital of Philadelphia received support from an unrestricted research grant from ZOLL Medical. Dana Niles and Vinay Nadkarni disclose that The Children{\textquoteright}s Hospital of Philadelphia receives funding from an unrestricted research grant from The American Heart Association. The remaining authors have disclosed that they do not have any potential conflicts of interest. Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",
year = "2020",
month = jan,
day = "1",
doi = "10.1016/j.resuscitation.2019.10.039",
language = "English (US)",
volume = "146",
pages = "56--63",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
}