{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:45:56Z","timestamp":1791989156109,"version":"4.4.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Objectives:<\/jats:title>\n Evaluate the association between cardiopulmonary resuscitation (CPR) ventilation rates and survival to hospital discharge, and identify novel ventilation targets.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n \n Multicenter prospective ancillary observational cohort study of the\n ICU-RESUS<\/jats:italic>\n trial (NCT02837497).\n <\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n A total of 18 ICUs from 10 U.S. clinical sites from October 2016 to March 2021.<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n Hospitalized children (\u2264 18 yr) with endotracheal or tracheostomy tubes and evaluable intra-arrest end-tidal carbon dioxide data to calculate ventilation rate.<\/jats:p>\n <\/jats:sec>\n \n Interventions:<\/jats:title>\n None.<\/jats:p>\n <\/jats:sec>\n \n Measurements and Main Results:<\/jats:title>\n \n Among 234 included events, 86 events (36.8%) had guideline-recommended (20\u201330 beats per min [bpm]) average ventilation rates during CPR. The association between guideline-recommended CPR ventilation rate and survival to hospital discharge was evaluated with Poisson regression using generalized estimating equations, controlling for a priori covariables (initial pulse status, immediate cause of arrest). We found no association between guideline-recommended ventilation rates and survival to hospital discharge (adjusted relative risk [aRR], 0.95; 95% CI, 0.75\u20131.21;\n p<\/jats:italic>\n = 0.68). In exploratory analyses, novel age-stratified ventilation rates were identified using natural cubic splines and subsequently evaluated in multivariable models. We identified potential thresholds (< 8 yr, \u2265 26 bpm; \u2265 8 yr, < 26 bpm). For children younger than 8 years, average CPR ventilation rate greater than or equal to 26 bpm was associated with improved survival to hospital discharge compared with less than 26 bpm (aRR, 1.32; 95% CI, 1.00\u20131.73;\n p<\/jats:italic>\n = 0.048).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n CPR ventilation rates in the currently recommended range (20\u201330 bpm) were not associated with survival in children with in-hospital cardiac arrest. In exploratory analyses in children younger than 8 years, higher ventilation rates (\u2265 26 bpm) were associated with improved survival and warrant confirmation in future studies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/ccm.0000000000007381","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:00:28Z","timestamp":1791986428000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Cardiopulmonary Resuscitation Ventilation Rates and Outcomes"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6097-8452","authenticated-orcid":false,"given":"Lindsay N.","family":"Shepard","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart H.","family":"Friess","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron W.","family":"Reeder","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Utah, Salt Lake City, UT."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Bender","sequence":"additional","affiliation":[{"name":"Center for Analytics of Dynamic Systems, Villanova University, Villanova, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen L.","family":"Meert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Michigan, Detroit, Michigan, Central Michigan University, Mt. Pleasant, MI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Mourani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children\u2019s Hospital, Little Rock, AR."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital at The Ohio State University, Columbus, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay M.","family":"Nadkarni","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Nataraj","sequence":"additional","affiliation":[{"name":"Center for Analytics of Dynamic Systems, Villanova University, Villanova, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chella A.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Utah Data Coordinating Center, University of Utah, Salt Lake City, UT."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Patterson","sequence":"additional","affiliation":[{"name":"Utah Data Coordinating Center, University of Utah, Salt Lake City, UT."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeraj","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mattel Children\u2019s Hospital at the University of California Los Angeles, Los Angeles, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather A.","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew R.","family":"Yates","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Nationwide Children\u2019s Hospital at The Ohio State University, Columbus, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan W.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Sutton","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, 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