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Published on: January 30, 2020
Pediatric defibrillation after cardiac arrest: initial response and outcome
Antonio Rodríguez-Núñez1, Jesús López-Herce, Cristina García
1Pediatric Emergency and Critical Care Division, Department ofPediatrics, Hospital Clínico Universitario de Santiago de Compostela, Spain. Antonio.Rodriguez.Nunez@sergas.es
Critical Care (London, England)
|August 3, 2006
Summary
Defibrillation is needed for 18% of pediatric cardiac arrests, but initial shock success is low. Despite return of spontaneous circulation (ROSC), long-term survival for children with cardiac arrest remains poor.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Emergency Medicine
Background:
- Shockable rhythms are infrequent in pediatric cardiac arrest.
- Defibrillation outcomes in children are not well-established.
- This study analyzes cardiopulmonary resuscitation (CPR) including defibrillation in pediatric patients.
Purpose of the Study:
- To analyze the effectiveness of defibrillation during CPR in children.
- To evaluate factors influencing survival rates in pediatric cardiac arrest.
- To assess the impact of shockable rhythms on patient outcomes.
Main Methods:
- Retrospective analysis of 241 pediatric cardiac arrest cases.
- Included 44 children treated with manual defibrillation.
- Data collected using Utstein style, focusing on return of spontaneous circulation (ROSC) and 1-year survival.
Main Results:
- Cardiac disease was the primary cause of arrest.
- Ventricular fibrillation (VF) or pulseless ventricular tachycardia (PVT) occurred in 56.8% during resuscitation.
- Initial shock terminated VF/PVT in only 18.1%; sustained ROSC achieved in 43.2%, but 1-year survival was 6.8%.
- Survival was better for initial shockable rhythms and older children.
- Lower doses (2 J/kg) showed higher survival rates.
Conclusions:
- Defibrillation is required in 18% of pediatric arrests, with limited success in terminating VF/PVT on first shock.
- Sustained ROSC does not guarantee long-term survival, which remains low.
- Outcomes are particularly poor when shockable rhythms develop during resuscitation; further research into new guidelines is needed.
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