• Curr Opin Crit Care · Jun 2017

    Review

    No small matter: pediatric resuscitation.

    • Taylor McCormick, Kevin McVaney, and Paul E Pepe.
    • aDepartment of Emergency Medicine, Denver Health Medical Center, Denver, Colorado bDepartment of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado cDepartments of Emergency Medicine, Internal Medicine, School of Public Health and Office of Health System Affairs, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
    • Curr Opin Crit Care. 2017 Jun 1; 23 (3): 193-198.

    Purpose Of ReviewTo present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR).Recent FindingsClinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied. Retrospective analyses of population-based POHCA registries revealed several associations: both bystander CPR and public-access defibrillation were associated with improved POHCA outcomes; conflicting results overshadow the benefits of conventional versus compression-only CPR; extracorporeal CPR was associated with improved PIHCA outcomes regardless of cause; intubation in PIHCA was associated with decreased survival, whereas there were no significant differences in outcomes between advanced airway management and bag-valve-mask ventilation in POHCA; and early epinephrine delivery in nonshockable rhythms during PIHCA was associated with improved outcomes. Length, age, and weight-based dosing systems can reduce time to medication delivery, quantitative errors, and anxiety among care providers.SummaryMounting evidence continues to align management priorities for resuscitation of children and adults.

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