RT Journal Article
T1 Pediatric defibrillation after cardiac arrest: initial response and outcome
A1 Rodríguez Núñez, Antonio
A1 López Herce, Jesús
A1 García, Cristina
A1 Domínguez, Pedro
A1 Carrillo, Angel
A1 Bellón, Jose María
A1 Spanish Study Group of Cardiopulmonary Arrest in Children, 
K1 Cardiac Arrest
K1 Ventricular Fibrillation
K1 Pediatric Intensive Care Unit
K1 Pulseless Electrical Activity
K1 Energy Dose
AB Shockable rhythms are rare in pediatric cardiac arrest and the results of defibrillation are uncertain. The objective of this study was to analyze the results of cardiopulmonary resuscitation that included defibrillation in childrenForty-four out of 241 children (18.2%) who were resuscitated from inhospital or out-of-hospital cardiac arrest had been treated with manual defibrillation. Data were recorded according to the Utstein style. Outcome variables were a sustained return of spontaneous circulation (ROSC) and one-year survival. Characteristics of patients and of resuscitation were evaluated.Cardiac disease was the major cause of arrest in this group. Ventricular fibrillation (VF) or pulseless ventricular tachycardia (PVT) was the first documented electrocardiogram rhythm in 19 patients (43.2%). A shockable rhythm developed during resuscitation in 25 patients (56.8%). The first shock (dose, 2 J/kg) terminated VF or PVT in eight patients (18.1%). Seventeen children (38.6%) needed more than three shocks to solve VF or PVT. ROSC was achieved in 28 cases (63.6%) and it was sustained in 19 patients (43.2%). Only three patients (6.8%), however, survived at 1-year follow-up. Children with VF or PVT as the first documented rhythm had better ROSC, better initial survival and better final survival than children with subsequent VF or PVT. Children who survived were older than the finally dead patients. No significant differences in response rate were observed when first and second shocks were compared. The survival rate was higher in patients treated with a second shock dose of 2 J/kg than in those who received higher doses. Outcome was not related to the cause or the location of arrest. The survival rate was inversely related to the duration of cardiopulmonary resuscitation.Defibrillation is necessary in 18% of children who suffer cardiac arrest. Termination of VF or PVT after the first defibrillation dose is achieved in a low percentage of cases. Despite a sustained ROSC being obtained in more than one-third of cases, the final survival remains low. The outcome is very poor when a shockable rhythm develops during resuscitation efforts. New studies are needed to ascertain whether the new international guidelines will contribute to improve the outcome of pediatric cardiac arrest
PB BMC
SN 1466-609X
YR 2006
FD 2006
LK http://hdl.handle.net/10347/22833
UL http://hdl.handle.net/10347/22833
LA eng
NO Rodríguez-Núñez, A., López-Herce, J., García, C. et al. Pediatric defibrillation after cardiac arrest: initial response and outcome. Crit Care 10, R113 (2006). https://doi.org/10.1186/cc5005
NO This study was supported by a Grant from the Fondo de InvestigacionesSanitarias, 00/0288
DS Minerva
RD 24 abr 2026