Return of Viable Cardiac Function After Sonographic Cardiac Standstill in Pediatric Cardiac Arrest
Katherine Steffen1, W Reid Thompson, Aliaksei Pustavoitau
1From the Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO; and Departments of †Pediatrics and ‡Anesthesia and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD.
Insights
Cardiac standstill on ultrasound during cardiac arrest typically predicts poor outcomes. However, in children, extracorporeal membrane oxygenation can restore heart function after standstill, suggesting it may not indicate death.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Echocardiography
Background:
- Sonographic cardiac standstill is a recognized sign of cardiac arrest.
- It is generally associated with a poor prognosis and failure to achieve return of spontaneous circulation in adults.
Observation:
- This report details three pediatric cases.
- These children experienced sonographic cardiac standstill during cardiac arrest.
Findings:
- All three children achieved return of spontaneous circulation and survived.
- Their cardiac function was restored with the use of extracorporeal membrane oxygenation (ECMO).
Implications:
- Sonographic cardiac standstill may not be an absolute predictor of cardiac death in pediatric patients.
- ECMO can be a life-saving intervention in children presenting with cardiac standstill during arrest.
- Further research is warranted to understand the prognostic implications of cardiac standstill in pediatric versus adult populations.
Abstract:
Sonographic cardiac standstill during adult cardiac arrest is associated with failure to get return to spontaneous circulation. This report documents 3 children whose cardiac function returned after standstill with extracorporeal membranous oxygenation. Sonographic cardiac standstill may not predict cardiac death in children.
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