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Postcardiac arrest syndrome: focus on the brain
Mioara D Manole1, Patrick M Kochanek, Ericka L Fink
1Department of Pediatrics, Children's Hospital of Pittsburgh, Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15260, USA. mioara.manole@chp.edu
Current Opinion in Pediatrics
|September 4, 2009
Summary
Recent advances in pediatric cardiac arrest care include distinguishing in-hospital from out-of-hospital events. Therapeutic hypothermia and extracorporeal membrane oxygenation show promise but require further research.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiology
- Neonatology
Background:
- Pediatric cardiac arrest research has advanced due to multicenter collaborations.
- Understanding differences between in-hospital and out-of-hospital pediatric cardiac arrest is crucial.
Purpose of the Study:
- To review recent developments in pediatric cardiac arrest over the past year.
- To identify areas requiring further investigation in pediatric resuscitation.
Main Methods:
- Retrospective review of in-hospital versus out-of-hospital pediatric cardiac arrest.
- Evaluation of therapeutic hypothermia studies in neonates and children.
- Assessment of extracorporeal membrane oxygenation (ECMO) in pediatric cardiac arrest.
Main Results:
- Significant differences in cause, severity, and outcomes exist between in-hospital and out-of-hospital pediatric cardiac arrest.
- Therapeutic hypothermia is recommended for term neonates at risk but lacks sufficient data for infants and children.
- Studies suggest hypothermia may be given to sicker pediatric patients, with similar or worse outcomes.
- Extracorporeal membrane oxygenation demonstrates promising outcomes in select pediatric cardiac arrest cases.
Conclusions:
- Therapeutic hypothermia and extracorporeal membrane oxygenation are key adjuncts to conventional care for pediatric cardiac arrest.
- Further research is needed for novel monitoring, treatment, and rehabilitation strategies post-pediatric cardiac arrest.
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