Related Experiment Video

Updated: Aug 6, 2026

Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest
04:55

Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest

Published on: May 26, 2023

Intra- and Peri-Operative Cardiac Arrest in Pediatric Patients: Epidemiology, Risk Factors, Mechanisms, and

Eleni Asimacopoulos1, Gloria M Al Karaki1, Kirsten C Odegard1

  • 1Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.

Paediatric Anaesthesia
|July 22, 2026
PubMed

Insights

Pediatric intraoperative and perioperative cardiac arrest (IOCA/POCA) remains a rare but serious event. Prevention through risk assessment and preparedness, alongside prompt resuscitation including extracorporeal cardiopulmonary resuscitation (ECPR), is crucial.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care

Background:

  • Intraoperative (IOCA) and perioperative cardiac arrest (POCA) in pediatric patients is a rare but severe complication.
  • Despite advancements, the incidence of IOCA/POCA in children has remained stable over the last 20 years.

Purpose of the Study:

  • To review the epidemiology, risk factors, and mechanisms of pediatric IOCA and POCA.
  • To provide clinicians with evidence-based management strategies for these events.

Main Methods:

  • Systematic review of current evidence on pediatric IOCA and POCA.
  • Synthesis of data on incidence, risk factors, and outcomes.

Main Results:

  • Incidence in pediatric noncardiac surgery is 3-22 per 10,000 cases.
  • Risk factors include young age, high ASA status, emergency surgery, congenital heart disease, and pulmonary hypertension.
  • Respiratory events are the primary cause of anesthesia-related arrest; cardiovascular causes have higher mortality.

Conclusions:

  • Prevention strategies focus on preoperative risk stratification and team preparedness.
  • Management emphasizes rapid recognition, high-quality CPR, and considering ECPR for refractory cases.

Keywords:
intraoperative cardiac arrestperioperative cardiac arrestpreoperative risk stratification

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