Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing.


OBJECTIVES:The aim of this study was to evaluate the relative frequency of pediatric in-hospital cardiopulmonary resuscitation events occurring in ICUs compared to general wards. We hypothesized that the proportion of pediatric cardiopulmonary resuscitation provided in ICUs versus general wards has increased over the past decade, and this shift is associated with improved resuscitation outcomes. DESIGN:Prospective and observational study. SETTING:Total of 315 hospitals in the American Heart Association's Get With The Guidelines-Resuscitation database. PATIENTS:Total of 5,870 pediatric cardiopulmonary resuscitation events between January 1, 2000 and September 14, 2010. Cardiopulmonary resuscitation events were defined as external chest compressions longer than 1 minute. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The primary outcome was proportion of total ICU versus general ward cardiopulmonary resuscitation events over time evaluated by chi-square test for trend. Secondary outcome included return of spontaneous circulation following the cardiopulmonary resuscitation event. Among 5,870 pediatric cardiopulmonary resuscitation events, 5,477 (93.3%) occurred in ICUs compared to 393 (6.7%) in inpatient wards. Over time, significantly more of these cardiopulmonary resuscitation events occurred in the ICU compared to the wards (test for trend: p<0.01), with a prominent shift noted between 2003 and 2004 (2000-2003: 87-91% vs 2004-2010: 94-96%). In a multivariable model controlling for within center variability and other potential confounders, return of spontaneous circulation increased in 2004-2010 compared with 2000-2003 (relative risk, 1.08; 95% CI, 1.03-1.13). CONCLUSIONS:In-hospital pediatric cardiopulmonary resuscitation is much more commonly provided in ICUs than in wards, and the proportion has increased significantly over the past decade, with concomitant increases in return of spontaneous circulation.


Crit Care Med


Critical care medicine


Berg RA,Sutton RM,Holubkov R,Nicholson CE,Dean JM,Harrison R,Heidemann S,Meert K,Newth C,Moler F,Pollack M,Dalton H,Doctor A,Wessel D,Berger J,Shanley T,Carcillo J,Nadkarni VM,Eunice Kennedy Shriver National Institute




Has Abstract


2013-10-01 00:00:00












  • Intensive care unit: how stressful for physicians?

    abstract::The ICU has been considered a psychologically stressful environment. Although numerous studies have investigated this stress in ICU nurses, virtually none have examined how stressful the ICU is for physicians. This prospective study compares housestaff physicians' ratings of stress in the ICU to other medical-surgical...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Eisendrath SJ,Link N,Matthay M

    更新日期:1986-02-01 00:00:00

  • Consequences of bed rest.

    abstract::Bed rest is frequently prescribed for critically ill patients because it is assumed to be beneficial for preventing complications, for conserving scarce metabolic resources, and for providing patient comfort. Furthermore, higher levels of physical activity in critically ill patients have been assumed to be impractical...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Brower RG

    更新日期:2009-10-01 00:00:00

  • Soluble triggering receptor expressed on myeloid cells-1 as an infection marker for patients with neutropenic fever.

    abstract:OBJECTIVE:To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein. DESIGN:Prospective, comparative, single-center study. SETTING:Hematology ward at a university hospital. SUBJECT...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Lin CH,Yao M,Hsu SC,Ho CC,Lin MT,Lin CA,Hu FC,Yu CJ,Tien HF

    更新日期:2011-05-01 00:00:00

  • Effect of Boarding on Mortality in ICUs.

    abstract:OBJECTIVES:Hospitals use a variety of strategies to maximize the availability of limited ICU beds. Boarding, which involves assigning patients to an open bed in a different subspecialty ICU, is one such practice employed when ICU occupancy levels are high, and beds in a particular unit are unavailable. Boarding disrupt...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Stretch R,Della Penna N,Celi LA,Landon BE

    更新日期:2018-04-01 00:00:00

  • Blood glucose concentration and outcome of critical illness: the impact of diabetes.

    abstract:OBJECTIVE:To study the impact of diabetes mellitus on the relationship between glycemia and mortality in critically ill patients. DESIGN:Retrospective observational study. SETTING:Intensive care units of two university hospitals. PATIENTS:Cohort of 4946 critically ill patients including 728 patients with diabetes me...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Egi M,Bellomo R,Stachowski E,French CJ,Hart GK,Hegarty C,Bailey M

    更新日期:2008-08-01 00:00:00

  • Nitric oxide indices in human septic shock.

    abstract:OBJECTIVES:To study the relation between nitrite, nitrate, nitrotyrosine, and nitrosothiols as NO indices in human septic shock. DESIGN:A prospective clinical study. SETTING:Intensive care units in a university hospital and a central county hospital. PATIENTS:Sixteen patients admitted for septic shock. Nine healthy ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Strand OA,Leone A,Giercksky KE,Kirkebøen KA

    更新日期:2000-08-01 00:00:00

  • Climate of Respect Evaluation in ICUs: Development of an Instrument (ICU-CORE).

    abstract:OBJECTIVES:To develop a valid, reliable measure that reflected the environment of respectfulness within the ICU setting. DESIGN:We developed a preliminary survey instrument based on conceptual domains of respect identified through prior qualitative analyses of ICU patient, family member, and clinician perspectives. Th...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Beach MC,Topazian R,Chan KS,Sugarman J,Geller G

    更新日期:2018-06-01 00:00:00

  • Comparative scintigraphy in oleic acid pulmonary microvascular injury.

    abstract::Computerized gamma scintigraphy revealed a significant (p less than 0.001) rising lung:heart radioactivity ratio, which has been called "slope of injury" or "slope index", with both 99mTechnetium-tagged human serum albumin (99mTc-HSA) and 99mTechnetium-tagged red blood cells (99Tc-RBC) after 0.05 or 0.2 ml/kg iv oleic...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Sugerman HJ,Hirsch JI,Tatum JL,Strash AM,Sharp DE,Greenfield LJ

    更新日期:1982-01-01 00:00:00

  • Management of aneurysmal subarachnoid hemorrhage.

    abstract:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Diringer MN

    更新日期:2009-02-01 00:00:00

  • Phenylmethimazole inhibits production of proinflammatory mediators and is protective in an experimental model of endotoxic shock*.

    abstract:BACKGROUND:One form of sepsis, or endotoxic shock, is a hyperactivated systemic response caused by excessive expression of proinflammatory mediators, which results from Gram-negative bacterial lipopolysaccharide-stimulated Toll-like receptor-4 signaling. This lipopolysaccharide signaling is known to consist of a MyD88-...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Benavides U,Gonzalez-Murguiondo M,Harii N,Lewis CJ,Schwartz AL,Giuliani C,Napolitano G,Dagia NM,Malgor R,McCall KD,Kohn LD

    更新日期:2012-03-01 00:00:00

  • Prevention of hemolysis-induced organ damage by nutritional activation of the vagal anti-inflammatory reflex*.

    abstract:OBJECTIVES:Acute hemolysis is associated with organ damage, inflammation, and impaired vascular function. Stimulation of the cholecystokinin-1 receptor-dependent vagal anti-inflammatory reflex with lipid-rich enteral nutrition was demonstrated to prevent tissue damage and attenuate inflammation. This study investigates...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: de Haan JJ,Windsant IV,Lubbers T,Hanssen SJ,Hadfoune M,Prinzen FW,Greve JW,Buurman WA

    更新日期:2013-11-01 00:00:00

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    abstract::Hypersensitivity reactions are defined as immunologically based adverse reactions to chemicals or medicinal agents. These reactions are common in the intensive care unit and can present as a simple, mildly symptomatic rash or as life-threatening anaphylactic reactions. Hypersensitivity reactions have traditionally bee...

    journal_title:Critical care medicine

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    authors: Kanji S,Chant C

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  • Association between nurse-physician collaboration and patient outcomes in three intensive care units.

    abstract:OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, an...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Baggs JG,Schmitt MH,Mushlin AI,Mitchell PH,Eldredge DH,Oakes D,Hutson AD

    更新日期:1999-09-01 00:00:00

  • Effect of high-frequency oscillation on blood flow to an atelectatic lung in closed-chest dogs.

    abstract::Seven dogs with electromagnetic flow probes implanted on their main (QT) and left (QL) pulmonary arteries, had catheters placed in their left atria and pulmonary artery, and were ventilated via Carlen's double-lumen endotracheal tubes. The effect of high-frequency oscillation (HFO) on the redistribution of pulmonary b...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Hall SM,Strawn WB,Levitzky MG

    更新日期:1984-05-01 00:00:00

  • Medical, legal and ethical issues in critical care.

    abstract::This report is intended to familiarize the reader with the current legislation concerning state definitions of death, the pertinent judicial decisions concerning termination of life support and the current status of medical/ethical committees. However, it is of paramount importance to all health care personnel to beco...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Wallace-Barnhill G,Roth MD,Briggs BA,Bastron DR,Barrocas A

    更新日期:1982-01-01 00:00:00

  • Exhaled tidal volume overestimation in mechanically ventilated patients with large cardiogenic oscillation.

    abstract:OBJECTIVES:In postcardiac surgery patients, we often noticed that monitored tidal volumes exceeded the ventilator settings. We investigated whether cardiogenic oscillation causes overestimation of tidal volume. DESIGN:Prospective, observational, clinical study. SETTING:Surgical intensive care unit in a national heart...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Imanaka H,Takeuchi M,Tachibana K,Nishimura M

    更新日期:2004-07-01 00:00:00

  • Phenotyping the Immune Response to Trauma: A Multiparametric Systems Immunology Approach.

    abstract:OBJECTIVE:Trauma induces a complex immune response that requires a systems biology research approach. Here, we used a novel technology, mass cytometry by time-of-flight, to comprehensively characterize the multicellular response to trauma. DESIGN:Peripheral blood mononuclear cells samples were stained with a 38-marker...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Seshadri A,Brat GA,Yorkgitis BK,Keegan J,Dolan J,Salim A,Askari R,Lederer JA

    更新日期:2017-09-01 00:00:00

  • Clinician Perspectives Regarding In-Hospital Cardiac Arrest Resuscitation: A Multicenter Survey.

    abstract:OBJECTIVES:Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest. DESIGN:Electronic survey. SETTING:Twenty-one hospitals in Utah and Idaho. SUBJECTS:All attending physicians, residents, and nurses in a m...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究


    authors: Peltan ID,Poll J,Sorensen J,Guidry D,Chandler M,Beninati W,Brown SM

    更新日期:2019-03-01 00:00:00

  • Case of fulminant hepatic failure due to unrecognized peripartum cardiomyopathy.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Fussell KM,Awad JA,Ware LB

    更新日期:2005-04-01 00:00:00

  • Postextubation hypoxemia treated with a continuous positive airway pressure mask.

    abstract::Twenty-seven surgical patients who developed post-extubation hypoxemia unresponsive to routine respiration therapy (incentive spirometry and chest physical therapy) received continuous positive airway pressure (CPAP) delivered through a mask at an inspired oxygen fraction (FIO2) of 0.45. All patients responded with an...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Dehaven CB Jr,Hurst JM,Branson RD

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  • Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs.

    abstract:BACKGROUND AND METHODS:This study was designed to explore the effect of mild cerebral and systemic hypothermia (34 degrees C) on outcome after prolonged cardiac arrest in dogs. After ventricular fibrillation with no flow of 10 min, and standard external CPR with epinephrine (low flow) from ventricular fibrillation time...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Sterz F,Safar P,Tisherman S,Radovsky A,Kuboyama K,Oku K

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  • Laser bronchoscopy in respiratory failure from malignant airway obstruction.

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    journal_title:Critical care medicine

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    authors: Stanopoulos IT,Beamis JF Jr,Martinez FJ,Vergos K,Shapshay SM

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  • Circulating Histones Are Major Mediators of Cardiac Injury in Patients With Sepsis.

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    journal_title:Critical care medicine

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    authors: Alhamdi Y,Abrams ST,Cheng Z,Jing S,Su D,Liu Z,Lane S,Welters I,Wang G,Toh CH

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  • Vecuronium by continuous infusion for neuromuscular blockade in infants and children.

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    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Eldadah MK,Newth CJ

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  • Critical care medicine use and cost among Medicare beneficiaries 1995-2000: major discrepancies between two United States federal Medicare databases.

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    journal_title:Critical care medicine

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    authors: Halpern NA,Pastores SM,Thaler HT,Greenstein RJ

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    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Rello J,Mariscal D,Gallego M,Valles J

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  • A closed system device for diagnosis and evaluation of neonatal pneumothoraces.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Fox WW,Eavey RD,Shaffer TH

    更新日期:1978-11-01 00:00:00

  • Manipulation of substrate utilization with somatostatin in patients with secondary multiple organ dysfunction syndrome.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Arnold J,Campbell IT,Hipkin LJ,Keegan M,Jenkins S,O'Sullivan E,Chadwick S

    更新日期:1995-01-01 00:00:00

  • Determining pulmonary resistance to gas flow during sinusoidal pressure wave mechanical ventilation.

    abstract::Standard techniques for measuring pulmonary resistance (RP) to gas flow in newborn infants yield results that are widely dispersed and difficult to interpret. The purpose of this study is to describe and evaluate a new improved method for determining RP which utilizes a sinusoidal pressure wave generator. Measurements...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Richardson P,Carlstrom JR

    更新日期:1983-07-01 00:00:00

  • Comparison of right atrial and pulmonary capillary wedge pressures.

    abstract::The right atrial pressure (Pra) was compared to the pulmonary capillary wedge pressure (Pcw) in 54 patients. In patients with heart disease, the correlation of Pra with Pcw was poor. However, in patients without clinical heart disease, Pra approximated Pcw, in both absolute number and change. This finding was independ...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Risk C,Rudo N,Falltrick R,Feeley T,Don HF

    更新日期:1978-05-01 00:00:00