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Early Epinephrine Improves the Stabilization of Initial Post-resuscitation Hemodynamics in Children With Non-shockable Out-of-Hospital Cardiac Arrest.
Lin, Yan-Ren; Li, Chao-Jui; Huang, Cheng-Chieh; Lee, Tsung-Han; Chen, Tren-Yi; Yang, Mei-Chueh; Chou, Chu-Chung; Chang, Chin-Fu; Huang, Hsi-Wen; Hsu, Hsiu-Ying; Chen, Wen-Liang.
Afiliación
  • Lin YR; Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
  • Li CJ; School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.
  • Huang CC; School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
  • Lee TH; Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung City, Taiwan.
  • Chen TY; Department of Leisure and Sports Management, Cheng Shiu University, Kaohsiung City, Taiwan.
  • Yang MC; Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
  • Chou CC; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
  • Chang CF; Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
  • Huang HW; Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan.
  • Hsu HY; Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
  • Chen WL; Department of Emergency Medicine, Changhua Christian Hospital, Changhua City, Taiwan.
Front Pediatr ; 7: 220, 2019.
Article en En | MEDLINE | ID: mdl-31245334
Background: In children with non-shockable out-of-hospital cardiac arrest, early epinephrine (EE) might help to establish the return of spontaneous circulation (ROSC) and be associated with survival. In the present study, we aimed to analyze the effects of EE on outcomes and post-resuscitation hemodynamics in children with non-shockable OHCA. Methods: This was a retrospective analysis of data from 216 children (<19 years) who had suffered non-traumatic and non-shockable OHCA and received epinephrine for resuscitation (Jan 1, 2006-Dec 31, 2014). Demographics, pre-/in-hospital information, and the time to the first dose of epinephrine were recorded. Early post-resuscitation hemodynamics (the first hour after sustained ROSC), survival and good neurological outcomes (Pediatric Cerebral Performance Category Scales 1 or 2) were analyzed by the time to epinephrine-classified as early (EE): <15 min, intermediate (IE): 15-30 min, or late (LE): >30 min. Results: Twenty-eight (13.0%) children survived to discharge, but only 17 (7.9%) had good neurological outcomes. In all, 41 (18.9%) children received EE; in comparison to IE and LE, this was significantly associated with tachycardia (73.9%) in the post-resuscitation period (p < 0.05). Tachycardia (OR: 7.41, 95% CI: 1.96-29.31) and hypertension (OR: 6.03, 95% CI: 1.85-13.77) were significantly associated with EE after adjusting for confounding factors. EE was also significantly associated with better overall outcomes than ME and LE (any ROSC, sustained ROSC, survival to the intensive care unit, admission, survival to discharge and good neurological outcomes, all p < 0.05). Conclusions: EE helped to establish ROSC but was also associated with more tachycardia and hypertension in the early post-resuscitation period. In children with non-traumatic and non-shockable OHCA, EE was associated with a higher survival rate and better neurological outcomes than were ME and LE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Pediatr Año: 2019 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Pediatr Año: 2019 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Suiza