{
    "abstract": "ECPR patients who receive guideline-compliant CPR will have improved survival to hospital discharge (SHD) compared to patients who do not receive guideline-compliant CPR, regardless of CPR duration.\nRetrospective, observational study from PediRES-Q of IHCA in children (<18\u00a0years) requiring ECMO to achieve ROSC. We assessed compliance of 60-sec chest compression (CC) epochs according to 2020 AHA guideline targets. Guideline-compliant CPR defined as\u00a0>\u00a060% epochs meeting compliance criteria for each target. Differences assessed utilizing Fisher's exact tests. Logistic regression used to assess guideline compliance and SHD, controlling for age, arterial line, duration of CPR, and clustering by site.\nWe analyzed 157 index ECPR events (> 5 epochs): 62 infants (<1 year), 52 children (1-<8 years), and 43 adolescents (8-\u226418\u00a0years) with CPR quality metric data from 20 sites. Median CPR duration 54 mins (IQR 40,66), median weight 12.0 kgs (IQR 6.0,28.5), and 74/157 (47%) with a cardiac diagnosis. Guideline compliance was not significantly associated with SHD after adjusted logistic regression; however, overall compliance was poor across age groups: 0% in\u00a0<\u00a01 year, 4% in 1-<8 years and 10% in 8-18\u00a0years. Age and duration of CPR were significantly associated with SHD, as 8-<18\u00a0years had 64% lower odds of SHD than\u00a0<\u00a08 year (aOR\u00a0=\u00a00.36 {0.17, 0.76; P\u00a0=\u00a00.007) and every minute increase in duration of CPR decreased survival odds by 2% (aOR\u00a0=\u00a00.98 {0.96,1.0; P\u00a0=\u00a00.02).\nWhile adherence to AHA guideline-complaint CPR was not significantly associated with SHD, patient age and CPR duration were significant predictors. These findings emphasize the need to better understand factors associated with survival after pediatric ECPR while also helping to drive improvements in ECPR care models.",
    "authors": [
        {
            "affiliation": "Medical City Children's Hospital, Department of Pediatrics, Cardiac Intensive Care, Dallas, TX, United States. Electronic address: tiaraymond@me.com.",
            "firstname": "Tia T",
            "initials": "TT",
            "lastname": "Raymond"
        },
        {
            "affiliation": "UT Southwestern Medical Center, Department of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Dallas, TX, United States.",
            "firstname": "Priscilla",
            "initials": "P",
            "lastname": "Yu"
        },
        {
            "affiliation": "Division of Cardiac Critical Care Medicine, Department of Pediatrics, University of Washington Seattle, Seattle, WA, United States.",
            "firstname": "Ivie",
            "initials": "I",
            "lastname": "Esangbedo"
        },
        {
            "affiliation": "Cohen Children's Medical Center of New York, Northwell Health, New Hyde Park, NY, United State.",
            "firstname": "Todd",
            "initials": "T",
            "lastname": "Sweberg"
        },
        {
            "affiliation": "UT Southwestern Medical Center, Department of Pediatrics, Divisions of Cardiology and Critical Care Medicine, Dallas, TX, United States.",
            "firstname": "Javier J",
            "initials": "JJ",
            "lastname": "Lasa"
        },
        {
            "affiliation": "Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, USA.",
            "firstname": "Xuemei",
            "initials": "X",
            "lastname": "Zhang"
        },
        {
            "affiliation": "Data Science and Biostatistics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, USA.",
            "firstname": "Heather",
            "initials": "H",
            "lastname": "Griffis"
        },
        {
            "affiliation": "The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.",
            "firstname": "Vinay",
            "initials": "V",
            "lastname": "Nadkarni"
        },
        {
            "affiliation": null,
            "firstname": null,
            "initials": null,
            "lastname": null
        }
    ],
    "conclusions": "While adherence to AHA guideline-complaint CPR was not significantly associated with SHD, patient age and CPR duration were significant predictors. These findings emphasize the need to better understand factors associated with survival after pediatric ECPR while also helping to drive improvements in ECPR care models.",
    "copyrights": "Copyright \u00a9 2025 Elsevier B.V. All rights reserved.",
    "doi": "10.1016/j.resuscitation.2025.110599",
    "journal": "Resuscitation",
    "keywords": [
        "Cardiopulmonary resuscitation",
        "Extracorporeal membrane oxygenation",
        "In-hospital cardiac arrest",
        "Pediatric",
        "Survival"
    ],
    "methods": null,
    "publication_date": "2025-04-10",
    "pubmed_id": "40204231",
    "results": "We analyzed 157 index ECPR events (> 5 epochs): 62 infants (<1 year), 52 children (1-<8 years), and 43 adolescents (8-\u226418\u00a0years) with CPR quality metric data from 20 sites. Median CPR duration 54 mins (IQR 40,66), median weight 12.0 kgs (IQR 6.0,28.5), and 74/157 (47%) with a cardiac diagnosis. Guideline compliance was not significantly associated with SHD after adjusted logistic regression; however, overall compliance was poor across age groups: 0% in\u00a0<\u00a01 year, 4% in 1-<8 years and 10% in 8-18\u00a0years. Age and duration of CPR were significantly associated with SHD, as 8-<18\u00a0years had 64% lower odds of SHD than\u00a0<\u00a08 year (aOR\u00a0=\u00a00.36 {0.17, 0.76; P\u00a0=\u00a00.007) and every minute increase in duration of CPR decreased survival odds by 2% (aOR\u00a0=\u00a00.98 {0.96,1.0; P\u00a0=\u00a00.02).",
    "title": "Outcomes after extracorporeal cardiopulmonary resuscitation in pediatric in-hospital cardiac arrest: does quality of CPR matter?",
    "xml": "<Element 'PubmedArticle' at 0x788506d914e0>"
}