Pediatric Post–Cardiac Arrest Care: A Scientific Statement From the American Heart Association

• Published in: Circulation Vol. 140; no. 6; pp. e194 - e233
• Main Authors: Topjian, Alexis A, de Caen, Allan, Wainwright, Mark S, Abella, Benjamin S, Abend, Nicholas S, Atkins, Dianne L, Bembea, Melania M, Fink, Ericka L, Guerguerian, Anne-Marie, Haskell, Sarah E, Kilgannon, J Hope, Lasa, Javier J, Hazinski, Mary Fran
• Format: Journal Article Conference Proceeding
• Language: English
• Published: United States by the American College of Cardiology Foundation and the American Heart Association, Inc 06.08.2019
• Subjects: Acute Kidney Injury - etiology; Acute Kidney Injury - therapy; Adrenal Insufficiency - etiology; Adrenal Insufficiency - therapy; Anticonvulsants - therapeutic use; Brain Damage, Chronic - etiology; Brain Damage, Chronic - prevention & control; Cardiomyopathies - etiology; Cardiomyopathies - prevention & control; Cardiopulmonary Resuscitation; Cardiovascular Agents - therapeutic use; Child; Combined Modality Therapy; Fluid Therapy; Glucose Metabolism Disorders - etiology; Glucose Metabolism Disorders - therapy; Heart Arrest - complications; Heart Arrest - epidemiology; Heart Arrest - rehabilitation; Heart Arrest - therapy; Humans; Hypnotics and Sedatives - therapeutic use; Hypothermia, Induced; Hypoxia-Ischemia, Brain - etiology; Hypoxia-Ischemia, Brain - physiopathology; Hypoxia-Ischemia, Brain - rehabilitation; Infections - etiology; Inflammation - etiology; Monitoring, Physiologic; Multiple Organ Failure - etiology; Multiple Organ Failure - prevention & control; Neuromuscular Blocking Agents - therapeutic use; Oxygen Inhalation Therapy; Prognosis; Reperfusion Injury - etiology; Reperfusion Injury - prevention & control; Respiratory Therapy; Time Factors; cardiopulmonary resuscitation; cardiopulmonary arrest; outcomes; targeted temperature management; post-cardiac arrest care; AHA Scientific Statements; child
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIR.0000000000000697

Successful resuscitation from cardiac arrest results in a post–cardiac arrest syndrome, which can evolve in the days to weeks after return of sustained circulation. The components of post–cardiac arrest syndrome are brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathophysiology. Pediatric post–cardiac arrest care focuses on anticipating, identifying, and treating this complex physiology to improve survival and neurological outcomes. This scientific statement on post–cardiac arrest care is the result of a consensus process that included pediatric and adult emergency medicine, critical care, cardiac critical care, cardiology, neurology, and nursing specialists who analyzed the past 20 years of pediatric cardiac arrest, adult cardiac arrest, and pediatric critical illness peer-reviewed published literature. The statement summarizes the epidemiology, pathophysiology, management, and prognostication after return of sustained circulation after cardiac arrest, and it provides consensus on the current evidence supporting elements of pediatric post–cardiac arrest care.