| アブストラクト | OBJECTIVES: To describe the rate, characteristics, and outcomes of pediatric extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest (IHCA) in Japan and evaluate temporal trends. DESIGN: Retrospective cohort using the Japanese Diagnosis Procedure Combination database from April 2011 to March 2022. SETTING: Nationwide dataset with approximately 50% of all acute care hospitalizations in Japan. PATIENTS: Children of less than 18 years who received ECPR for IHCA. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcomes were temporal trends in ECPR utilization and survival to hospital discharge. Among the 8209 pediatric patients with IHCA, 312 received ECPR: the median (interquartile range [IQR]) age was 2 years (IQR, 0-13 yr); and 52% were male. Annual need for ECPR was 3.6 (IQR, 2.9-4.8) cases per 100 IHCA events, with a significant upward trend 2011-2022 (p = 0.0001). Annual need for ECPR was 0.038 (IQR, 0.031-0.046) per 1000 pediatric hospital admissions, and we failed to identify an associated upward trend over time (p = 0.056). Survival to hospital discharge increased from 17.6% in 2011 to 37.5% in 2022, with a significant upward trend over time in the unadjusted analysis (p = 0.036); however, the adjusted temporal analysis failed to show an associated upward trend over time. Survival varied by age and illness category. Secondary analyses showed that cardiac diagnoses, as opposed to noncardiac diagnoses, were associated with higher overall survival: 105 of 213 (49.3%) vs. 24 of 89 (27%); percentage difference, 22.3% (95% CI, 11.3-33.4%); p = 0.0002. CONCLUSIONS: In our national dataset from Japan 2011-2022, we have found that pediatric ECPR for IHCA was used infrequently. Survival to hospital discharge showed a temporal increase over time. These trends may reflect changes in patient volume, guideline implementation, or more refined patient selection for ECPR, as well as resuscitation processes and better systems of clinical practice. |
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| ジャーナル名 | Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies |
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| Pubmed追加日 | 2026/9/11 |
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| 投稿者 | Ikeyama, Takanari; Shiima, Yuko; Kurosawa, Hiroshi; Matsuo, Yuichiro; Ohbe, Hiroyuki; Matsui, Hiroki; Yasunaga, Hideo |
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| 組織名 | Center for Pediatric Emergency and Critical Care Medicine, Aichi Children's;Health and Medical Center, Japan.;Department of Comprehensive Pediatric Medicine, Nagoya University Graduate School;of Medicine, Japan.;Medilux Research Center, Nara Institute of Science and Technology, Japan.;Center for Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's;Hospital, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Japan.;Department of Emergency and Critical Care Medicine, Tohoku University Hospital,;Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42725820/ |
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