Cardiac arrest in children

Abstract

Paediatric cardiac arrests are rare and represent only 2% of out-of-hospital cardiac arrests. The majority (i.e. 70%) are due to poor oxygenation or infections. Survival at discharge after out-of-hospital cardiac arrest is 2.6–4% and 45% after in-hospital cardiac arrest. European guidelines are written according to evidence-based sciences, aiming to improve survival rate without sequelae. The last modifications of the European guidelines are summarised in this article: healthcare providers should search for signs of life to diagnose circulatory arrest; ventilation is required in cardiopulmonary resuscitation in children; and interruption of chest compressions should be reduced at the minimum to limit no-flow time. Automated external defibrillator (AED) may be used in children aged more than 1 year (preferably with an attenuator before the age of 8 years). In infants, a manual defibrillator is preferred. But if arrhythmia is likely, in the absence of manual defibrillator, AED could be used. Advanced life support follows the same rules in adult. Cuffed tracheal tubes can be used in children if the size is chosen according to an appropriate formula and the pressure cuff monitored. Post-cardiac arrest management aims at brain protection and prevention of secondary organ damage and includes therapeutic hypothermia.