Katherine Cashen1, Ron W Reeder2, Tageldin Ahmed3, Michael J Bell4, Robert A Berg5, Candice Burns6, Joseph A Carcillo7, Todd C Carpenter8, J Michael Dean2, J Wesley Diddle4, Myke Federman9, Ericka L Fink7, Aisha H Frazier10,11, Stuart H Friess12, Kathryn Graham5, Mark Hall13, David A Hehir5, Christopher M Horvat7, Leanna L Huard9, Tensing Maa13, Arushi Manga12, Patrick S McQuillen14, Ryan W Morgan5, Peter M Mourani8, Vinay M Nadkarni5, Maryam Y Naim5, Daniel Notterman15, Chella A Palmer2, Murray M Pollack4, Carleen Schneiter8, Matthew P Sharron4, Neeraj Srivastava9, David Wessel4, Heather A Wolfe5, Andrew R Yates13, Athena F Zuppa5, Robert M Sutton5, Kathleen L Meert3. 1. Department of Pediatrics, Duke Children's Hospital, Duke University, Durham, NC. 2. Department of Pediatrics, University of Utah, Salt Lake City, UT. 3. Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI. 4. Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC. 5. Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA. 6. Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI. 7. Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA. 8. Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. 9. Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA. 10. Department of Pediatrics, Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE. 11. Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA. 12. Department of Pediatrics, Washington University School of Medicine, St. Louis, MO. 13. Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH. 14. Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA. 15. Department of Molecular Biology, Princeton University, Princeton, NJ.
Abstract
OBJECTIVES: To evaluate associations between sodium bicarbonate use and outcomes during pediatric in-hospital cardiac arrest (p-IHCA). DESIGN: Prespecified secondary analysis of a prospective, multicenter cluster randomized interventional trial. SETTING: Eighteen participating ICUs of the ICU-RESUScitation Project (NCT02837497). PATIENTS: Children less than or equal to 18 years old and greater than or equal to 37 weeks post conceptual age who received chest compressions of any duration from October 2016 to March 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Child and event characteristics, prearrest laboratory values (2-6 hr prior to p-IHCA), pre- and intraarrest hemodynamics, and outcomes were collected. In a propensity score weighted cohort, the relationships between sodium bicarbonate use and outcomes were assessed. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge with favorable neurologic outcome. Of 1,100 index cardiopulmonary resuscitation events, median age was 0.63 years (interquartile range, 0.19-3.81 yr); 528 (48.0%) received sodium bicarbonate; 773 (70.3%) achieved ROSC; 642 (58.4%) survived to hospital discharge; and 596 (54.2%) survived to hospital discharge with favorable neurologic outcome. Among the weighted cohort, sodium bicarbonate use was associated with lower survival to hospital discharge rate (adjusted odds ratio [aOR], 0.7; 95% CI, 0.54-0.92; p = 0.01) and lower survival to hospital discharge with favorable neurologic outcome rate (aOR, 0.69; 95% CI, 0.53-0.91; p = 0.007). Sodium bicarbonate use was not associated with ROSC (aOR, 0.91; 95% CI, 0.62-1.34; p = 0.621). CONCLUSIONS: In this propensity weighted multicenter cohort study of p-IHCA, sodium bicarbonate use was common and associated with lower rates of survival to hospital discharge.
OBJECTIVES: To evaluate associations between sodium bicarbonate use and outcomes during pediatric in-hospital cardiac arrest (p-IHCA). DESIGN: Prespecified secondary analysis of a prospective, multicenter cluster randomized interventional trial. SETTING: Eighteen participating ICUs of the ICU-RESUScitation Project (NCT02837497). PATIENTS: Children less than or equal to 18 years old and greater than or equal to 37 weeks post conceptual age who received chest compressions of any duration from October 2016 to March 2021. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Child and event characteristics, prearrest laboratory values (2-6 hr prior to p-IHCA), pre- and intraarrest hemodynamics, and outcomes were collected. In a propensity score weighted cohort, the relationships between sodium bicarbonate use and outcomes were assessed. The primary outcome was survival to hospital discharge. Secondary outcomes included return of spontaneous circulation (ROSC) and survival to hospital discharge with favorable neurologic outcome. Of 1,100 index cardiopulmonary resuscitation events, median age was 0.63 years (interquartile range, 0.19-3.81 yr); 528 (48.0%) received sodium bicarbonate; 773 (70.3%) achieved ROSC; 642 (58.4%) survived to hospital discharge; and 596 (54.2%) survived to hospital discharge with favorable neurologic outcome. Among the weighted cohort, sodium bicarbonate use was associated with lower survival to hospital discharge rate (adjusted odds ratio [aOR], 0.7; 95% CI, 0.54-0.92; p = 0.01) and lower survival to hospital discharge with favorable neurologic outcome rate (aOR, 0.69; 95% CI, 0.53-0.91; p = 0.007). Sodium bicarbonate use was not associated with ROSC (aOR, 0.91; 95% CI, 0.62-1.34; p = 0.621). CONCLUSIONS: In this propensity weighted multicenter cohort study of p-IHCA, sodium bicarbonate use was common and associated with lower rates of survival to hospital discharge.
Authors: Lars W Andersen; Tia T Raymond; Robert A Berg; Vinay M Nadkarni; Anne V Grossestreuer; Tobias Kurth; Michael W Donnino Journal: JAMA Date: 2016-11-01 Impact factor: 56.272
Authors: Jerry P Nolan; Robert A Berg; Lars W Andersen; Farhan Bhanji; Paul S Chan; Michael W Donnino; Swee Han Lim; Matthew Huei-Ming Ma; Vinay M Nadkarni; Monique A Starks; Gavin D Perkins; Peter T Morley; Jasmeet Soar Journal: Circulation Date: 2019-09-16 Impact factor: 29.690
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: Resuscitation Date: 2004-12 Impact factor: 5.262
Authors: Kathleen L Meert; Amy Donaldson; Vinay Nadkarni; Kelly S Tieves; Charles L Schleien; Richard J Brilli; Robert S B Clark; Donald H Shaffner; Fiona Levy; Kimberly Statler; Heidi J Dalton; Elise W van der Jagt; Richard Hackbarth; Robert Pretzlaff; Lynn Hernan; J Michael Dean; Frank W Moler Journal: Pediatr Crit Care Med Date: 2009-09 Impact factor: 3.624
Authors: Lars W Andersen; Katherine M Berg; Brian Z Saindon; Joseph M Massaro; Tia T Raymond; Robert A Berg; Vinay M Nadkarni; Michael W Donnino Journal: JAMA Date: 2015-08-25 Impact factor: 56.272
Authors: Robert A Berg; Robert M Sutton; Ron W Reeder; John T Berger; Christopher J Newth; Joseph A Carcillo; Patrick S McQuillen; Kathleen L Meert; Andrew R Yates; Rick E Harrison; Frank W Moler; Murray M Pollack; Todd C Carpenter; David L Wessel; Tammara L Jenkins; Daniel A Notterman; Richard Holubkov; Robert F Tamburro; J Michael Dean; Vinay M Nadkarni Journal: Circulation Date: 2017-12-26 Impact factor: 29.690
Authors: Alexis A Topjian; Tia T Raymond; Dianne Atkins; Melissa Chan; Jonathan P Duff; Benny L Joyner; Javier J Lasa; Eric J Lavonas; Arielle Levy; Melissa Mahgoub; Garth D Meckler; Kathryn E Roberts; Robert M Sutton; Stephen M Schexnayder Journal: Circulation Date: 2020-10-21 Impact factor: 29.690