Santiago O Valdes1, Aaron J Donoghue2, Derek B Hoyme3, Rachel Hammond4, Marc D Berg3, Robert A Berg2, Ricardo A Samson3. 1. Department of Pediatrics and Steele Children's Research Center, University of Arizona College of Medicine, Tucson, AZ, United States; Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, United States. Electronic address: svaldes@bcm.edu. 2. Departments of Anesthesiology and Critical Care and Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, United States. 3. Department of Pediatrics and Steele Children's Research Center, University of Arizona College of Medicine, Tucson, AZ, United States. 4. Westat Biostatistics & Data Management Core, Children's Hospital of Philadelphia, United States.
Abstract
AIM: To determine the association between amiodarone and lidocaine and outcomes in children with cardiac arrest with pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF). BACKGROUND: Current AHA guidelines for CPR and emergency cardiovascular care recommend amiodarone for cardiac arrest in children associated with shock refractory pVT/VF, based on a single pediatric study and extrapolation from adult data. METHODS: Retrospective cohort study from the Get With the Guidelines-Resuscitation database for in-patient cardiac arrest. Patients<18 years old with pVT/VF cardiac arrest were included. Patients receiving amiodarone or lidocaine prior to arrest or whose initial arrest rhythm was unknown were excluded. Univariate analysis was performed to assess the association between patient and event factors and clinical outcomes. Multivariate analysis was performed to address independent association between lidocaine and amiodarone use and outcomes. RESULTS: Of 889 patients, 171 (19%) received amiodarone, 295 (33%) received lidocaine, and 82 (10%) received both. Return of spontaneous circulation (ROSC) occurred in 484/889 (54%), 24-h survival in 342/874 (39%), and survival to hospital discharge in 194/889 (22%). Lidocaine was associated with improved ROSC (adjusted OR 2.02, 95% CI 1.36-3), and 24-h survival (adjusted OR 1.66, 95% CI 1.11-2.49), but not hospital discharge. Amiodarone use was not associated with ROSC, 24h survival, or survival to discharge. CONCLUSIONS: For children with in-hospital pVT/VF, lidocaine use was independently associated with improved ROSC and 24-h survival. Amiodarone use was not associated with superior rates of ROSC, survival at 24h. Neither drug was associated with survival to hospital discharge.
AIM: To determine the association between amiodarone and lidocaine and outcomes in children with cardiac arrest with pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF). BACKGROUND: Current AHA guidelines for CPR and emergency cardiovascular care recommend amiodarone for cardiac arrest in children associated with shock refractory pVT/VF, based on a single pediatric study and extrapolation from adult data. METHODS: Retrospective cohort study from the Get With the Guidelines-Resuscitation database for in-patientcardiac arrest. Patients<18 years old with pVT/VF cardiac arrest were included. Patients receiving amiodarone or lidocaine prior to arrest or whose initial arrest rhythm was unknown were excluded. Univariate analysis was performed to assess the association between patient and event factors and clinical outcomes. Multivariate analysis was performed to address independent association between lidocaine and amiodarone use and outcomes. RESULTS: Of 889 patients, 171 (19%) received amiodarone, 295 (33%) received lidocaine, and 82 (10%) received both. Return of spontaneous circulation (ROSC) occurred in 484/889 (54%), 24-h survival in 342/874 (39%), and survival to hospital discharge in 194/889 (22%). Lidocaine was associated with improved ROSC (adjusted OR 2.02, 95% CI 1.36-3), and 24-h survival (adjusted OR 1.66, 95% CI 1.11-2.49), but not hospital discharge. Amiodarone use was not associated with ROSC, 24h survival, or survival to discharge. CONCLUSIONS: For children with in-hospital pVT/VF, lidocaine use was independently associated with improved ROSC and 24-h survival. Amiodarone use was not associated with superior rates of ROSC, survival at 24h. Neither drug was associated with survival to hospital discharge.
Authors: Peter A Meaney; Vinay M Nadkarni; Dianne L Atkins; Marc D Berg; Ricardo A Samson; Mary Fran Hazinski; Robert A Berg Journal: Pediatrics Date: 2010-12-20 Impact factor: 7.124
Authors: Marc D Berg; Ricardo A Samson; Robyn J Meyer; Lani L Clark; Terence D Valenzuela; Robert A Berg Journal: Resuscitation Date: 2005-10 Impact factor: 5.262
Authors: John C Somberg; Steven J Bailin; Charles I Haffajee; Walter P Paladino; Nicholas Z Kerin; Duane Bridges; Sandor Timar; Janos Molnar Journal: Am J Cardiol Date: 2002-10-15 Impact factor: 2.778
Authors: J Philip Saul; William A Scott; Stephen Brown; Pablo Marantz; Valeria Acevedo; Susan P Etheridge; James C Perry; John K Triedman; Susan W Burriss; Paul Cargo; Jay Graepel; Eeva-Kaarina Koskelo; Rebecca Wang Journal: Circulation Date: 2005-11-29 Impact factor: 29.690
Authors: P J Kudenchuk; L A Cobb; M K Copass; R O Cummins; A M Doherty; C E Fahrenbruch; A P Hallstrom; W A Murray; M Olsufka; T Walsh Journal: N Engl J Med Date: 1999-09-16 Impact factor: 91.245
Authors: Ian Jacobs; Vinay Nadkarni; Jan Bahr; Robert A Berg; John E Billi; Leo Bossaert; Pascal Cassan; Ashraf Coovadia; Kate D'Este; Judith Finn; Henry Halperin; Anthony Handley; Johan Herlitz; Robert Hickey; Ahamed Idris; Walter Kloeck; Gregory Luke Larkin; Mary Elizabeth Mancini; Pip Mason; Gregory Mears; Koenraad Monsieurs; William Montgomery; Peter Morley; Graham Nichol; Jerry Nolan; Kazuo Okada; Jeffrey Perlman; Michael Shuster; Petter Andreas Steen; Fritz Sterz; James Tibballs; Sergio Timerman; Tanya Truitt; David Zideman Journal: Circulation Date: 2004-11-23 Impact factor: 29.690
Authors: M M Scheinman; J H Levine; D S Cannom; T Friehling; H A Kopelman; D A Chilson; E V Platia; D J Wilber; P R Kowey Journal: Circulation Date: 1995-12-01 Impact factor: 29.690
Authors: A Zaritsky; V Nadkarni; M F Hazinski; G Foltin; L Quan; J Wright; D Fiser; D Zideman; P O'Malley; L Chameides Journal: Circulation Date: 1995-10-01 Impact factor: 29.690
Authors: Allan R de Caen; Marc D Berg; Leon Chameides; Cheryl K Gooden; Robert W Hickey; Halden F Scott; Robert M Sutton; Janice A Tijssen; Alexis Topjian; Élise W van der Jagt; Stephen M Schexnayder; Ricardo A Samson Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Samantha H Dallefeld; Andrew M Atz; Ram Yogev; Janice E Sullivan; Amira Al-Uzri; Susan R Mendley; Matthew Laughon; Christoph P Hornik; Chiara Melloni; Barrie Harper; Andrew Lewandowski; Jeff Mitchell; Huali Wu; Thomas P Green; Michael Cohen-Wolkowiez Journal: J Pharmacokinet Pharmacodyn Date: 2018-02-12 Impact factor: 2.410
Authors: Ryan W Morgan; Matthew P Kirschen; Todd J Kilbaugh; Robert M Sutton; Alexis A Topjian Journal: JAMA Pediatr Date: 2021-03-01 Impact factor: 16.193
Authors: Do Kyun Kim; Won Kyoung Jhang; Ji Yun Ahn; Ji Sook Lee; Yoon Hee Kim; Bongjin Lee; Gi Beom Kim; Jin-Tae Kim; June Huh; June Dong Park; Sung Phil Chung; Sung Oh Hwang Journal: Clin Exp Emerg Med Date: 2016-07-05
Authors: Jarosław Gorący; Paweł Stachowiak; Arkadiusz Krejczy; Patrycja Piątek; Iwona Gorący Journal: Int J Environ Res Public Health Date: 2022-02-23 Impact factor: 3.390