Lidocaine versus amiodarone for pediatric in-hospital cardiac arrest: An observational study

Research output: Contribution to journalArticle

Authors

  • Mathias J. Holmberg
  • Catherine E. Ross
  • Dianne L. Atkins
  • Santiago O. Valdes
  • Michael W. Donnino
  • Lars W. Andersen
  • Anne Marie Guerguerian
  • Elizabeth E. Foglia
  • Ericka Fink
  • Javier J. Lasa
  • Joan Roberts
  • Jordan Duval-Arnould
  • Melanie Bembea
  • Michael Gaies
  • Monica Kleinman
  • Punkaj Gupta
  • Robert M. Sutton
  • Taylor Sawyer

External Institution(s)

  • Harvard University
  • Aarhus University
  • University of Iowa
  • Baylor College of Medicine

Details

Original languageEnglish (US)
Pages (from-to)191-201
Number of pages11
JournalResuscitation
Volume149
StatusPublished - Apr 2020
Peer-reviewedYes

Abstract

Background: Lidocaine and amiodarone are both included in the pediatric cardiac arrest guidelines as treatments of shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, although there is limited evidence to support this recommendation. Methods: In this cohort study from the Get With The Guidelines – Resuscitation registry, we included pediatric patients (≤18 years) with an in-hospital cardiac arrest between 2000 and 2018, who presented with an initial or subsequent shockable rhythm (ventricular fibrillation and pulseless ventricular tachycardia). Patients receiving amiodarone were matched to patients receiving lidocaine based on a propensity score, calculated from multiple patient, event, and hospital characteristics. Results: A total of 365 patients were available for the analysis, of which 180 (49%) patients were matched on the propensity score. The median age in the raw cohort was 6 (quartiles, 0.5–14) years, 164 (45%) patients were female, and 238 (65%) patients received an antiarrhythmic for an initial shockable rhythm. In the matched cohort, there were no statistically significant differences between patients receiving lidocaine compared to amiodarone in return of spontaneous circulation (RR, 0.99 [95%CI, 0.82–1.19]; p = 0.88), survival to 24 h (RR, 1.02 [95%CI, 0.76–1.38]; p = 0.88), survival to hospital discharge (RR, 1.01 [95%CI, 0.63–1.63]; p = 0.96), and favorable neurological outcome (RR, 0.65 [95%CI, 0.35–1.21]; p = 0.17). The results remained consistent in multiple sensitivity analyses. Conclusions: In children with cardiac arrest receiving antiarrhythmics for a shockable rhythm, there was no significant difference in clinical outcomes between those receiving lidocaine compared to amiodarone.

    Research areas

  • Amiodarone, Antiarrhythmics, Cardiac arrest, Heart arrest, Lidocaine, Pediatrics

Citation formats

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Holmberg, MJ, Ross, CE, Atkins, DL, Valdes, SO, Donnino, MW, Andersen, LW, Guerguerian, AM, Foglia, EE, Fink, E, Lasa, JJ, Roberts, J, Duval-Arnould, J, Bembea, M, Gaies, M, Kleinman, M, Gupta, P, Sutton, RM & Sawyer, T 2020, 'Lidocaine versus amiodarone for pediatric in-hospital cardiac arrest: An observational study', Resuscitation, vol. 149, pp. 191-201. https://doi.org/10.1016/j.resuscitation.2019.12.033