Impact of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological outcomes in children with out-of-hospital cardiac arrests: A prospective,nationwide,population-based cohort study

Background-the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (cpr) on neurological outcomes in children is unclear. we investigated whether dispatcher-assisted bystander cpr shows favorable neurological outcomes (cerebral performance category scale 1 or 2) in children with out-of-hospital cardiac arrest (ohca). methods and results-children (n=5009,age < 18 years) with ohca were selected from a nationwide utstein-style japanese database (2008-2010) and divided into 3 groups: no bystander cpr (n=2287); bystander cpr with dispatcher instruction (n=2019); and bystander cpr without dispatcher instruction (n=703) groups. the primary endpoint was favorable neurological outcome at 1 month post-ohca. dispatcher cpr instruction was offered to 53.9% of patients,significantly increasing bystander cpr provision rate (adjusted odds ratio [aor],7.51; 95% confidence interval [ci],6.60 to 8.57). bystander cpr with and without dispatcher instruction were significantly associated with improved 1-month favorable neurological outcomes (aor,1.81 and 1.68; 95% ci,1.24 to 2.67 and 1.07 to 2.62,respectively),compared to no bystander cpr. conventional cpr was associated with increased odds of 1-month favorable neurological outcomes irrespective of etiology of cardiac arrest (aor,2.30; 95% ci,1.56 to 3.41). however,chest-compression-only cpr was not associated with 1-month meaningful outcomes (aor,1.05; 95% ci,0.67 to 1.64). conclusions-in children with ohca,dispatcher-assisted bystander cpr increased bystander cpr provision rate and was associated with improved 1-month favorable neurological outcomes,compared to no bystander cpr. conventional bystander cpr was associated with greater likelihood of neurologically intact survival,compared to chest-compression-only cpr,irrespective of cardiac arrest etiology. © 2014 the authors.