Evidence map›Paper›PMID 29279413›Full record

Observational studyCirculation2018

Association Between Diastolic Blood Pressure During Pediatric In-Hospital Cardiopulmonary Resuscitation and Survival.

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 and 11 more

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 93 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 2 pooled it
16.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04428060 naterminatednot on this mapstarted 2020, after this paper: background citation

Assessment of the Efficacy of Personalized Physiology-guided Resuscitation in Patients With Cardiac Arrest: The PERSEUS Pilot Randomized Trial

TypeinterventionalSponsorUniversity of ThessalyRan2020 to 2022Enrolled14ConditionsCardiac Arrest, Cardiopulmonary Arrest With Successful ResuscitationArmsPERSEUS CPR, Standard CPR
NCT07114510 narecruitingnot on this mapstarted 2025, after this paper: background citation

OPTImal Ventilation to Improve Pediatric Cardiac Arrest Outcomes (OPTI-VENT)

TypeinterventionalSponsorChildren's Hospital of PhiladelphiaRan2025 to 2030Enrolled1,530ConditionsCardiac Arrest (CA)ArmsOPTI-VENT Bundle, Transition, None - control
3 · Its place in the literature

Who cites it

93 citing papers in PubMed, 2 syntheses or guidelines pooled it, 203 citations in OpenAlex.

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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 7 institutions in 5 countries.

Robert A BergDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania (R.A.B., R.M.S., V.M.N). bergra@email.chop.edu.
Robert M SuttonDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania (R.A.B., R.M.S., V.M.N).
Ron W ReederDepartment of Pediatrics, University of Utah, Salt Lake City (R.W.R., R.H., J.M.D.).
John T BergerDepartment of Pediatrics, Children's National Medical Center, Washington, DC (J.T.B., M.M.P., D.L.W.).
Christopher J NewthDepartment of Anesthesiology, Children's Hospital of Los Angeles, University of Southern California Keck College of Medicine (C.J.N.).
Joseph A CarcilloDepartment of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh, PA (J.A.C.).
Patrick S McQuillenDepartment of Pediatrics, Benioff Children's Hospital, University of California, San Francisco (P.S.M.).
Kathleen L MeertDepartment of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit (K.L.M.).
Andrew R YatesDepartment of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus (A.R.Y.).
Rick E HarrisonDepartment of Pediatrics, Mattel Children's Hospital, University of California, Los Angeles (R.E.H.).
Frank W MolerDepartment of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor (F.W.M.).
Murray M PollackDepartment of Pediatrics, Children's National Medical Center, Washington, DC (J.T.B., M.M.P., D.L.W.).
Todd C CarpenterDepartment of Pediatrics, Denver Children's Hospital, University of Colorado, Aurora (T.C.C.).
David L WesselDepartment of Pediatrics, Children's National Medical Center, Washington, DC (J.T.B., M.M.P., D.L.W.).
Tammara L JenkinsEunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (T.L.J., R.F.T.).
Daniel A NottermanDepartment of Molecular Biology, Princeton University, NJ (D.A.N).
Richard HolubkovDepartment of Pediatrics, University of Utah, Salt Lake City (R.W.R., R.H., J.M.D.).
Robert F TamburroEunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (T.L.J., R.F.T.).
J Michael DeanDepartment of Pediatrics, University of Utah, Salt Lake City (R.W.R., R.H., J.M.D.).
Vinay M NadkarniDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania (R.A.B., R.M.S., V.M.N).
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) PICqCPR (Pediatric Intensive Care Quality of Cardio-Pulmonary Resuscitation) Investigators
Al-Mustafa International University · IRKatherine Hospital · AULandis International (United States) · USMARK Resources (United States) · USPeterson (Norway) · NOWeber and Weber (Germany) · DEWhitney Museum of American Art · US

Funding

Data Coordinating Center for the Collaborative Pediatric Critical Care Research NetworkU01HD049934 · NICHD · UNIVERSITY OF UTAH · PI DEAN, JONATHAN MICHAEL · 2005 to 2020
$35.2M
Physiologically Guided Ventilator Strategies in ChildrenU10HD050012 · NICHD · CHILDREN'S HOSPITAL OF LOS ANGELES · PI NEWTH, CHRISTOPHER JOHN · 2005 to 2014
$3.7M
Neurodevelopmental Outcome after Cardiac Intensive CareU10HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI WESSEL, DAVID LLOYD · 2005 to 2014
$3.7M
Collaborative Pediatric Critical Care Research NetworkU10HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2005 to 2014
$3.2M
Metoclopramide prevents PICU nosocomial infectionU10HD049983 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARCILLO, JOSEPH A · 2005 to 2014
$3.1M
Collaborative Pediatric Critical Care Research Network (CPCCRN) at Children's NationalUG1HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI POLLACK, MURRAY MICHAEL, WESSEL, DAVID LLOYD · 2015 to 2020
$1.8M
Pediatric Critical Care Research Network at Children's Hospital of PhiladelphiaUG1HD063108 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN, ZUPPA, ATHENA F. · 2015 to 2020
$1.7M
Collaborative Research to Validate Biomarkers of Pediatric ARDSUG1HD083166 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MCQUILLEN, PATRICK SEAN, SAPRU, ANIL · 2015 to 2020
$1.6M
Renewal Application for the Childrens Hospital of Pittsburgh Collaborative Pediatric Critical Care Research Network SiteUG1HD049983 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARCILLO, JOSEPH A · 2015 to 2020
$1.6M
Collaborative Pediatric Critical Care Research NetworkUG1HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2015 to 2020
$1.6M
Collaborative Network Study of Airway Microbiome and Host Responses in Pediatric Respiratory FailureUG1HD083171 · NICHD · UNIVERSITY OF COLORADO DENVER · PI CARPENTER, TODD C · 2015 to 2020
$1.5M
Collaborative Pediatric Critical Care Research Network (UG1)UG1HD083170 · NICHD · RESEARCH INST NATIONWIDE CHILDREN'S HOSP · PI HALL, MARK W · 2015 to 2020
$1.5M
NICHD NIH HHS RL1 HD107773NICHD NIH HHS U01 HD049934NICHD NIH HHS U10 HD049981NICHD NIH HHS U10 HD049983NICHD NIH HHS U10 HD050012NICHD NIH HHS U10 HD050096NICHD NIH HHS U10 HD063106NICHD NIH HHS U10 HD063108NICHD NIH HHS U10 HD063114NICHD NIH HHS UG1 HD049981NICHD NIH HHS UG1 HD049983NICHD NIH HHS UG1 HD050012NICHD NIH HHS UG1 HD050096NICHD NIH HHS UG1 HD063106NICHD NIH HHS UG1 HD063108NICHD NIH HHS UG1 HD083166NICHD NIH HHS UG1 HD083170NICHD NIH HHS UG1 HD083171
6 · The paper itself

Abstract

backgroundOn the basis of laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, the American Heart Association recommends using blood pressure to guide pediatric CPR. However, evidence-based blood pressure targets during pediatric CPR remain an important knowledge gap for CPR guidelines.

methodsAll children ≥37 weeks' gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring before and during CPR between July 1, 2013, and June 31, 2016, were included. Mean DBP during CPR and Utstein-style standardized cardiac arrest data were collected. The hypothesis was that DBP ≥25 mm Hg during CPR in infants and ≥30 mm Hg in children ≥1 year old would be associated with survival. Primary outcome was survival to hospital discharge. Secondary outcome was survival to hospital discharge with favorable neurological outcome, defined as Pediatric Cerebral Performance Categories 1 to 3 or no worse than prearrest baseline. Multivariable Poisson regression models with robust error estimates were used to estimate the relative risk of outcomes.

resultsBlinded investigators analyzed blood pressure waveforms during CPR from 164 children, including 60% <1 year old, 60% with congenital heart disease, and 54% after cardiac surgery. The immediate cause of arrest was hypotension in 67%, respiratory decompensation in 44%, and arrhythmia in 19%. Median duration of CPR was 8 minutes (quartiles, 3 and 27 minutes). Ninety percent survived the event, 68% with return of spontaneous circulation and 22% by extracorporeal life support. Forty-seven percent survived to hospital discharge, and 43% survived to discharge with favorable neurological outcome. Maintaining mean DBP ≥25 mm Hg in infants and ≥30 mm Hg in children ≥1 year old occurred in 101 of 164 children (62%) and was associated with survival (adjusted relative risk, 1.7; 95% confidence interval, 1.2-2.6;

conclusionsThese data demonstrate that mean DBP ≥25 mm Hg during CPR in infants and ≥30 mm Hg in children ≥1 year old was associated with greater likelihood of survival to hospital discharge and survival with favorable neurological outcome.

Indexed as

Arterial PressureCardiopulmonary ResuscitationCerebrovascular CirculationInpatientsAdolescentAdolescent DevelopmentAge FactorsBrainChildChild DevelopmentChild, PreschoolDiastoleDisability EvaluationFemaleHeart ArrestHospital Mortalitycardiopulmonary resuscitationheart arrestpediatricssurvivaltreatment outcomes

Identifiers

PMID29279413
PMCPMC5916041
OpenAlexW2778505339

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.