Association of CPR simulation program characteristics with simulated and actual performance during paediatric in-hospital cardiac arrest

the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatrics Critical Care Research Network (CPCCRN), National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Aim: To evaluate associations between characteristics of simulated point-of-care cardiopulmonary resuscitation (CPR) training with simulated and actual intensive care unit (ICU) CPR performance, and with outcomes of children after in-hospital cardiac arrest. Methods: This is a pre-specified secondary analysis of the ICU-RESUScitation Project; a prospective, multicentre cluster randomized interventional trial conducted in 18 ICUs from October 2016–March 2021. Point-of-care bedside simulations with real-time feedback to allow multidisciplinary ICU staff to practice CPR on a portable manikin were performed and quality metrics (rate, depth, release velocity, chest compression fraction) were recorded. Actual CPR performance was recorded for children 37 weeks post-conceptual age to 18 years who received chest compressions of any duration, and included intra-arrest haemodynamics and CPR mechanics. Outcomes included survival to hospital discharge with favourable neurologic status. Results: Overall, 18,912 point-of-care simulations were included. Simulation characteristics associated with both simulation and actual performance included site, participant discipline, and timing of simulation training. Simulation characteristics were not associated with survival with favourable neurologic outcome. However, participants in the top 3 sites for improvement in survival with favourable neurologic outcome were more likely to have participated in a simulation in the past month, on a weekday day, to be nurses, and to achieve targeted depth of compression and chest compression fraction goals during simulations than the bottom 3 sites. Conclusions: Point-of-care simulation characteristics were associated with both simulated and actual CPR performance. More recent simulation, increased nursing participation, and simulation training during daytime hours may improve CPR performance.

Original languageEnglish (US)
Article number109939
StatePublished - Oct 2023

All Science Journal Classification (ASJC) codes

  • Emergency
  • Cardiology and Cardiovascular Medicine
  • Emergency Medicine


  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Child
  • Infant
  • Neonate
  • Simulation


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