Abstract
Background
This study aimed to investigate the ventilation practice during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC) in children.
Methods
An online survey of CPR practices was designed and sent to healthcare professionals treating children.
Results
A total of 477 healthcare professionals from 46 countries responded to this survey; 92.7% were physicians and 64.2% worked in pediatric intensive care units. Specific CPR guidelines were used by 97.7% of respondents. The respiratory rate most frequently used for children over 12 months was 13 to 20 respirations per minute (rpm) (46% in intubated and 41.8% in non-intubated). For infants under 12 months, the most frequently used respiratory rate was 21 to 30 rpm in intubated patients (37.3%): in non-intubated infants, 13 to 20 rpm (26.5%) and 21 to 30 rpm (26.5%) were used with the same frequency. In North America, the respiratory rate most widely used was 7 to 12 rpm; higher rates (13 to 20 rpm and 21 to 30 rpm) were used in Europe and Latin America (P<0.001). After ROSC, no significant differences in the respiratory rates used were found between the continents. More than 40% of healthcare professionals had a target oxygen saturation below 94%; more than 10% used a target arterial PCO2 below 35 mmHg and more than 13% above 45 mmHg.
Conclusions
There is considerable variation in the management of ventilation of children in cardiac arrest, and international recommendations are not being followed in a high percentage of cases.
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Acknowledgements
We would like to thank Ignacio Manrique of the Spanish Pediatric and Neonatal CPR Group, The Spanish Society of Pediatric Intensive Care, Vinay Nadkarni and Bettina von Dessauer, and The World Federation of Pediatric Intensive Care Societies for their assistance in distributing the survey.
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González, R., Pascual, L., Sava, A. et al. Ventilation during cardiopulmonary resuscitation in children: a survey on clinical practice. World J Pediatr 13, 544–550 (2017). https://doi.org/10.1007/s12519-017-0061-2
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DOI: https://doi.org/10.1007/s12519-017-0061-2