Evidence map›Paper›PMID 33147522›Full record

ArticleResuscitation2021

Trends over time in drug administration during pediatric in-hospital cardiac arrest in the United States.

Catherine E Ross, Ari Moskowitz, Anne V Grossestreuer, Mathias J Holmberg, Lars W Andersen, Tuyen T Yankama, Robert A Berg, Amanda O'Halloran, Monica E Kleinman, Michael W Donnino and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.3field-weighted citation impact, top 18% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 15 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Resuscitation after birth and beyond in the neonatal intensive care unit: NRP or PALS?Journal of perinatology : official journal of the California Perinatal Association · 2025
    Review
  5. Early Sodium Bicarbonate Use in Pediatric In-Hospital Cardiac Arrest: A Single-Center, Retrospective Cohort Study, 2013-2023.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2025
    Article
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Catherine E RossDivision of Medical Critical Care, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, 333 Longwood Avenue, Boston, MA, 02115, USA; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA. Electronic address: Catherine.Ross@childrens.harvard.edu.
Ari MoskowitzCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02115, USA.
Anne V GrossestreuerCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA.
Mathias J HolmbergCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA; Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark; Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark.
Lars W AndersenCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA; Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200, Aarhus, Denmark.
Tuyen T YankamaDepartment of Pharmacy, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA.
Robert A BergDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Amanda O'HalloranDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
Monica E KleinmanDivision of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
Michael W DonninoCenter for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 359 Brookline Avenue, Boston, MA, 02115, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02115, USA.
American Heart Association’s Get With The Guidelines – Resuscitation Investigators
Beth Israel Deaconess Medical Center · USBoston Children's Hospital · USChildren's Hospital of Philadelphia · US

Funding

Thaimine as an adjunct metabolic resuscitator in cardiac arrestK24HL127101 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI DONNINO, MICHAEL WILLIAM · 2015 to 2024
$1.2M
Thiamine as a Renal Protective Agent in Septic ShockK23GM128005 · NIGMS · BETH ISRAEL DEACONESS MEDICAL CENTER · PI MOSKOWITZ, ARI · 2018 to 2021
$761k
NHLBI NIH HHS K24 HL127101NIGMS NIH HHS K23 GM128005
6 · The paper itself

Abstract

aimsTo describe trends in pediatric in-hospital cardiac arrest drug administration and to assess temporal associations of the Pediatric Advanced Life Support (PALS) guideline changes with drug usage.

methodsPediatric patients <18 years old with in-hospital cardiac arrest recorded in the American Heart Association Get With The Guidelines-Resuscitation database between 2002 and 2018 were included. The annual adjusted odds of receiving each intra-arrest medication was determined. The association between changes in the PALS Guidelines and medication use over time was assessed interrupted time series analyses.

resultsA total of 6107 patients were analyzed. The adjusted odds of receiving lidocaine (0.33; 95% CI, 0.18, 0.61; p < 0.001), atropine (0.19; 95% CI 0.12, 0.30; p < 0.001) and bicarbonate (0.54; 95% CI 0.35, 0.86; p = 0.009) were lower in 2018 compared to 2002. For lidocaine, there were no significant changes in the step (-2.1%; 95% CI, -5.9%, 1.6%; p = 0.27) after the 2010 or 2015 (Step: -1.5%; 95% CI, -8.0%, 5.0; p = 0.65) guideline releases. There were no significant changes in the step for bicarbonate (-2.3%; 95% CI, -7.6%, 3.0%; p = 0.39) after the 2010 updates. For atropine, there was a downward step change after the 2010 guideline release (-5.9%; 95% CI, -10.5%, -1.3%; p = 0.01).

conclusionsChanges to the PALS guidelines for lidocaine and bicarbonate were not temporally associated with acute changes in the use of these medications; however, better alignment with these updates was observed over time. A minor update to the language surrounding atropine in the PALS text was associated with a modest acute change in the observed use of atropine. Future studies exploring other factors that influence prescribers in pediatric IHCA are needed.

Indexed as

Cardiopulmonary ResuscitationHeart ArrestPharmaceutical PreparationsAdolescentAtropineChildHospitals, PediatricHumansLidocaineUnited StatesAtropineLidocainePharmaceutical PreparationsCardiac arrestGuidelinesPediatric Advanced Life Support

Identifiers

PMID33147522
PMCPMC7851749
OpenAlexW3097550857

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.