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December 1984, Vol 138, No. 12 >
Article | December 1984

The Effectiveness of Pediatric Cardiopulmonary Resuscitation FREE

JAMES P. ORLOWSKI, MD
Am J Dis Child. 1984;138(12):1098. doi:10.1001/archpedi.1984.02140500003001.
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Disturbing data are beginning to appear in the medical literature that the success rate in pediatric cardiopulmonary resuscitation (CPR) is no better, and possibly worse, than the success rate in adult CPR. This poor outcome is especially prominent in children in whom cardiac arrest occurs. This success rate for pediatric CPR is even more dismal when success is defined as meaningful (minimal or no neurologic deficit) long-term survival rather than reestablishment of spontaneous cardiac and respiratory function.

In this issue of the AJDC, Torphy et al1 extend the data that have been previously accumulated from their institution.2 In this study they retrospectively examined the records of all children who presented to the Milwaukee Children's Hospital emergency department in cardiac arrest or developed cardiac arrest while in the emergency department. Patients who sustained only a respiratory arrest but maintained a palpable pulse were excluded. The reason for this exclusion

REFERENCES

1 +
Torphy DE, Minter MG, Thompson BM:  Cardiorespiratory arrest and resuscitation of children . AJDC 1984;;138:1099-1102.
2 +
Lewis JK, Minter MG, Eshelman SJ, et al:  Outcome of pediatric resuscitation . Ann Emerg Med 1983;;12:297-299.
3 +
Nichols DG, Kettrick RG, Swedlow DB, et al:  Factors influencing outcome of cardiopulmonary arrest in children , abstracted. Crit Care Med 1984;;12:287.
4 +
Eisenberg M, Bergner L, Hallstrom A:  Epidemiology of cardiac arrest and resuscitation in children . Ann Emerg Med 1983;;12:672-674.
5 +
Friesen RM, Duncan P, Tweed WA, et al:  Appraisal of pediatric cardiopulmonary resuscitation . Can Med Assoc J 1982;;126:1055-1058.
6 +
O'Rourke PP:  Out-of-hospital cardiac arrest in pediatric patients: Outcome , abstracted. Crit Care Med 1984;;12:283.
7 +
Eisenberg M, Bergner L, Hallstrom A:  Paramedic programs and out-of-hospital cardiac arrest: I. Factors associated with successful resuscitation . Am J Public Health 1979;;69:30-38.
8 +
Liberthson RR, Nagel EL, Hirschman JC, et al:  Prehospital ventricular fibrillation . N Engl J Med 1974;;219:317-321.
9 +
Eisenberg MS, Hallstrom A, Bergner L:  Long-term survival after out-of-hospital cardiac arrest . N Engl J Med 1982;;306:1340-1343.
10 +
Carlsson CA, von Essen C, Löfgren J:  Factors affecting the clinical course of patients with severe head injuries . J Neurosurg 1968;;29: 242-251.
11 +
Plum F, Posner JB: The Diagnosis of Stupor and Coma , ed 3. Philadelphia, FA Davis Co, 1980;,  chap 7 .
12 +
Orlowski JP:  Pediatric cardiopulmonary resuscitation . Emerg Med Clin 1983;;1:3-25.
13 +
Orlowski JP:  Cardiopulmonary resuscitation in children . Pediatr Clin North Am 1980;;27: 495-512.
14 +
Orlowski JP:  Optimal position for external cardiac massage in infants and children , abstracted. Crit Care Med 1984;;12:224.
15 +
Turkel H:  Intraosseous infusion . AJDC 1983;;137:706.
16 +
Valdes MM:  Intraosseous fluid administration in emergencies . Lancet 1977;;1:1235-1236.
17 +
Rossetti V, Thompson BM, Aprahamian C, et al:  Difficulty and delay in intravascular access in pediatric arrests , abstracted. Ann Emerg Med 1984;;13:406.
18 +
Safar P:  Resuscitation after brain ischemia , in Grenvik A, Safar P (eds): Brain Failure and Resuscitation . New York, Churchill Livingstone, 1981;, pp 155-184.
19 +
Orlowski JP:  Pediatric cerebral resuscitation . Cleve Clin Q 1983;;50:317-321.
20 +
Breivik H, Safar P, Sands P, et al:  Clinical feasibility trials of barbiturate therapy after cardiac arrest . Crit Care Med 1978;;6:228-244.
21 +
Bruce DA, Gennarelli TA, Langfitt TW:  Resuscitation from coma due to head injury . Crit Care Med 1978;;6:254-269.
22 +
Abramson NS, Safar P, Detre K, et al:  Brain resuscitation clinical trial I study group: Thiopental loading in cardiopulmonary resuscitation (CPR) survivors , abstracted. Crit Care Med 1984;;12:227.
23 +
White BC, Wiegenstein JG, Winegar CD:  Brain ischemic anoxia: Mechanism of injury . JAMA 1984;;251:1586-1590.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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References

1 +
Torphy DE, Minter MG, Thompson BM:  Cardiorespiratory arrest and resuscitation of children . AJDC 1984;;138:1099-1102.
2 +
Lewis JK, Minter MG, Eshelman SJ, et al:  Outcome of pediatric resuscitation . Ann Emerg Med 1983;;12:297-299.
3 +
Nichols DG, Kettrick RG, Swedlow DB, et al:  Factors influencing outcome of cardiopulmonary arrest in children , abstracted. Crit Care Med 1984;;12:287.
4 +
Eisenberg M, Bergner L, Hallstrom A:  Epidemiology of cardiac arrest and resuscitation in children . Ann Emerg Med 1983;;12:672-674.
5 +
Friesen RM, Duncan P, Tweed WA, et al:  Appraisal of pediatric cardiopulmonary resuscitation . Can Med Assoc J 1982;;126:1055-1058.
6 +
O'Rourke PP:  Out-of-hospital cardiac arrest in pediatric patients: Outcome , abstracted. Crit Care Med 1984;;12:283.
7 +
Eisenberg M, Bergner L, Hallstrom A:  Paramedic programs and out-of-hospital cardiac arrest: I. Factors associated with successful resuscitation . Am J Public Health 1979;;69:30-38.
8 +
Liberthson RR, Nagel EL, Hirschman JC, et al:  Prehospital ventricular fibrillation . N Engl J Med 1974;;219:317-321.
9 +
Eisenberg MS, Hallstrom A, Bergner L:  Long-term survival after out-of-hospital cardiac arrest . N Engl J Med 1982;;306:1340-1343.
10 +
Carlsson CA, von Essen C, Löfgren J:  Factors affecting the clinical course of patients with severe head injuries . J Neurosurg 1968;;29: 242-251.
11 +
Plum F, Posner JB: The Diagnosis of Stupor and Coma , ed 3. Philadelphia, FA Davis Co, 1980;,  chap 7 .
12 +
Orlowski JP:  Pediatric cardiopulmonary resuscitation . Emerg Med Clin 1983;;1:3-25.
13 +
Orlowski JP:  Cardiopulmonary resuscitation in children . Pediatr Clin North Am 1980;;27: 495-512.
14 +
Orlowski JP:  Optimal position for external cardiac massage in infants and children , abstracted. Crit Care Med 1984;;12:224.
15 +
Turkel H:  Intraosseous infusion . AJDC 1983;;137:706.
16 +
Valdes MM:  Intraosseous fluid administration in emergencies . Lancet 1977;;1:1235-1236.
17 +
Rossetti V, Thompson BM, Aprahamian C, et al:  Difficulty and delay in intravascular access in pediatric arrests , abstracted. Ann Emerg Med 1984;;13:406.
18 +
Safar P:  Resuscitation after brain ischemia , in Grenvik A, Safar P (eds): Brain Failure and Resuscitation . New York, Churchill Livingstone, 1981;, pp 155-184.
19 +
Orlowski JP:  Pediatric cerebral resuscitation . Cleve Clin Q 1983;;50:317-321.
20 +
Breivik H, Safar P, Sands P, et al:  Clinical feasibility trials of barbiturate therapy after cardiac arrest . Crit Care Med 1978;;6:228-244.
21 +
Bruce DA, Gennarelli TA, Langfitt TW:  Resuscitation from coma due to head injury . Crit Care Med 1978;;6:254-269.
22 +
Abramson NS, Safar P, Detre K, et al:  Brain resuscitation clinical trial I study group: Thiopental loading in cardiopulmonary resuscitation (CPR) survivors , abstracted. Crit Care Med 1984;;12:227.
23 +
White BC, Wiegenstein JG, Winegar CD:  Brain ischemic anoxia: Mechanism of injury . JAMA 1984;;251:1586-1590.

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