Abstract 16949: Conventional Bystander CPR is Associated With Higher Neurologically Favorable Survival in Children Compared to Compression Only CPR Following Pediatric Out of Hospital Cardiac Arrest

Abstract

Introduction: There are conflicting data regarding the benefit of conventional bystander CPR (BCPR) compared to compression only BCPR (CO-BCPR) for children following out of hospital cardiac arrest (OHCA). Hypothesis: Conventional BCPR is associated with improved outcome compared to CO-BCPR in infants, children and adolescents following OHCA. Methods: An analysis of the Cardiac Arrest Registry to Enhance Survival was conducted. Inclusion criteria were age ≤ 18 years and non-traumatic OHCA from 2013 through 2017. The primary outcome was neurologically favorable survival (cerebral performance category score of 1 or 2). Age groups included infants (≤1 year), children (2-11 years), and adolescents (≥12 years). Results: Of 6249 cardiac arrests, 1191 received conventional BCPR, 1386 received CO-BCPR, and 3672 received no BCPR. The highest neurologically favorable survival was associated with conventional BCPR (adjusted proportion12.5%, OR 2.5, 95% CI 1.9, 3.2) for the overall cohort compared to CO-BCPR (9%, OR 1.6, 95% CI 1.2, 2.0) and no BCPR (6.4%). Conventional BCPR was significantly associated with improved neurologically favorable survival vs. no BCPR in the overall cohort and in all age groups (infants 9.4% vs. 5.4%, children 17.9% vs. 6.2%, adolescents 14% vs. 8,1%, p-value (for all) <0.001). Conventional BCPR was also significantly associated with improved neurologically favorable survival vs. CO-BCPR in the overall cohort and for infants (9.4% vs. 6.1%, p=0.02). CO-BCPR was significantly associated with improved neurologically favorable survival compared to no BCPR in the overall cohort and in children (13.5% vs. 6.2%, p<0.001), but not in infants or adolescents. Conclusion: Conventional BCPR was associated with higher neurologically favorable survival compared to no BCPR in all children and compared to CO-BCPR in most age groups. These results support current AHA/ILCOR recommendations for the provision of conventional BCPR in pediatric OHCA.