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Part 8: Pediatric Advanced Life Support: 2025 American Heart Association and American Academy of Pediatrics

Javier J Lasa, Gurpreet S Dhillon, Jonathan P Duff

    Pediatrics
    |October 22, 2025
    PubMed

    Insights

    These pediatric advanced life support guidelines offer critical updates for healthcare professionals on cardiopulmonary resuscitation (CPR) and emergency cardiovascular care for children. They cover resuscitation strategies, drug administration, and post-cardiac arrest management to improve pediatric outcomes.

    Area of Science:

    • Cardiovascular Medicine
    • Pediatric Emergency Medicine
    • Resuscitation Science

    Background:

    • The American Heart Association and American Academy of Pediatrics provide updated guidelines for pediatric advanced life support (PALS).
    • These guidelines address resuscitation and emergency cardiovascular care for infants and children up to 18 years old, excluding newborns.
    • The guidelines are applicable across various settings including community, prehospital, and hospital environments.

    Purpose of the Study:

    • To provide a comprehensive resource for healthcare professionals on identifying and treating pediatric patients in pre-arrest, intra-arrest, and post-cardiac arrest states.
    • To detail current evidence-based recommendations for pediatric resuscitation and emergency cardiovascular care.
    • To identify knowledge gaps in resuscitation science to guide future research.

    Main Methods:

    • Consensus-based recommendations derived from systematic reviews of resuscitation science.
    • Inclusion of diverse emergency care situations beyond standard cardiopulmonary arrest.
    • Focus on practical application for healthcare providers in various clinical settings.

    Main Results:

    • Detailed strategies for ventilation, advanced airway management, and drug administration with weight-based dosing during CPR.
    • Specific recommendations on defibrillation energy doses, CPR physiology monitoring, and extracorporeal CPR.
    • Comprehensive guidance on post-cardiac arrest care, including temperature, blood pressure, oxygenation, neurologic monitoring, prognostication, and survivorship.
    • Management protocols for shock, arrhythmias, myocarditis, congenital heart disease, pulmonary hypertension, and traumatic cardiac arrest.

    Conclusions:

    • The updated guidelines provide essential information for optimizing pediatric resuscitation and emergency cardiovascular care.
    • Addressing identified knowledge gaps is crucial for advancing pediatric resuscitation science and future guideline development.
    • Consistent application of these guidelines aims to improve survival and outcomes for critically ill children.

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