Conventional versus hands-only cardiopulmonary resuscitation by bystanders for pediatrics with out-of-hospital cardiac arrest: A systematic review and meta-analysis


Creative Commons License

Kietlinska M., Krawczyk A., Witkowski G., Pruc M., Tomaszewska M., Kurek K., ...Daha Fazla

CARDIOLOGY JOURNAL, cilt.32, sa.6, ss.579-587, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 32 Sayı: 6
  • Basım Tarihi: 2025
  • Doi Numarası: 10.5603/cj.104135
  • Dergi Adı: CARDIOLOGY JOURNAL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.579-587
  • Bezmiâlem Vakıf Üniversitesi Adresli: Evet

Özet

Background: Sudden cardiac arrest (SCA) in pediatric populations is a rare yet critical medical emergency characterized by high mortality and significant neurological impairment among survivors. This systematic review and meta-analysis aim to synthesize existing evidence on pediatric resuscitation techniques, focusing on survival rates, neurological outcomes, and the effectiveness of chest compression-only resuscitation (HCPR) versus standard resuscitation (CCPR), thereby addressing current gaps in clinical understanding and informing future guidelines. Methods: Following PRISMA guidelines, we systematically searched the PubMed, Cochrane Library, and Embase databases for trials comparing HCPR versus CCPR during pediatric resuscitation. We used a comparative meta-analysis to estimate the odds ratio of prehospital return of spontaneous circulation (ROSC), 1-month survival rate, and survival with favorable neurological outcome. Study level odds ratios (ORs) and their 95% confidence intervals (CI) were pooled using random effects. Results: Prehospital ROSC incidence did not significantly differ between HCPR and CCPR, including subgroup analysis based on cause of cardiac arrest. One-month survival rate was 12.3% in HCPR and 18.0% in CCPR (p = 0.04). Additionally, HCPR was less effective in non-cardiac arrest cases and in children over one year of age. Favorable neurological outcomes at one month were also lower for HCPR (6.3%) compared to CCPR (9.0%; p < 0.001), with similar trends observed across subgroups of noncardiac arrest origin and varying age groups. Conclusions: A pediatric resuscitation technique based solely on chest compressions shows lower efficacy in terms of survival at one month and quality of return of neurological function compared to standard resuscitation.