The first quantitative report of ventilation rate during in-hospital resuscitation of older XXXX and adolescents.

@entity1 @entity299 @entity1167
AIM: During adult @entity1167 , rescuers frequently provide ventilations at rates exceeding those recommended by the @entity299 ( @entity299 ). Excessive ventilation is associated with worse clinical outcome after adult @entity1167 . This study is the first to characterize ventilation rate adherence to @entity299 guidelines during in-hospital pediatric @entity1167 resuscitation. @entity1 AND METHODS: We prospectively enrolled @entity1 and adolescents (>= 8 years of age) who suffered a @entity1167 in a pediatric intensive care unit (PICU) or emergency department (ED) of a tertiary-care pediatric hospital. Ventilation rate (breaths per minute [bpm]) was monitored via changes in chest wall impedance (CWI) recorded by defibrillator electrode pads during cardiopulmonary resuscitation (CPR). RESULTS: Twenty-four CPR events were enrolled yielding 588 thirty-second CPR epochs. The proportion of CPR epochs with ventilation rates exceeding @entity299 guidelines (>10 bpm) was 63% (CI(95) 59-67%), significantly higher than our a priori hypothesis of 30% (p<0.01). The proportion of CPR epochs with ventilation rates exceeding 20 bpm was 20% (CI(95) 17-23). After controlling for location of arrest and initial event rhythm, resuscitations that occurred on nights/weekends were 3.6 times (CI(95): 1.6-7.9, p<0.01) more likely to have a ventilation rate exceeding @entity299 guidelines. CONCLUSIONS: During in-hospital pediatric @entity1167 , rescuers frequently provide artificial ventilations at rates in excess of @entity299 guidelines, with twenty percent of CPR time having ventilation rates double that recommended. Excessive ventilation was particularly common during CPR events that occurred on nights/weekends.
