2016, Number 3
2015 AHA (American Heart Association) new changes in the guidelines for pediatric basic and advanced life support. Section 2: Key issues and major changes in pediatric cardiopulmonary resuscitation for health care providers
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Language: Spanish
References: 10
Page: 93-100
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ABSTRACT
This section of the article “2015 new changes in the guidelines for pediatric basic and advanced life support” summarizes the main recommendations and rationale for the 2015 update of the AHA (American Heart Association) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, based on a systematic review of international literature on the science of resuscitation by members of the Pediatric Task Force of the International Liaison Committee on Resuscitation, published in 2015. The key and major changes in the recommendations of the AHA guidelines for pediatric basic life support include initiating the sequence of resuscitation with chest compressions, new algorithms for pediatric cardiopulmonary resuscitation, high-quality cardiopulmonary resuscitation, and emphasis on the need for compressions and ventilation in pediatric basic life support. The topics of pediatric advanced life support classified into three phases of cardiac arrest include: pre-arrest care: use of early warning scores and rapid response teams, resuscitation with fluids in septic shock, atropine as premedication for emergency tracheal intubation, treatment for myocarditis and dilated cardiomyopathy; intra-arrest care: resuscitation with extracorporeal membrane oxygenation, exhaled carbon dioxide threshold, prognostic factors, invasive hemodynamic monitoring, vasopressors for resuscitation, amiodarone and lidocaine for ventricular fibrillation/pulseless ventricular tachycardia, optimal energy dose for defibrillation; post-arrest care: targeted temperature and blood pressure management after cardiac arrest in infants and children, optimal levels of PaO2 and PaCO2, use of fluids, inotropes and vasopressors to improve perfusion, the predictive value of electroencephalogram, post-cardiac arrest evolution predictors. This update is not a comprehensive review of the 2010 guides of the American Heart Association, since it only introduces new or revised recommendations on the most important or controversial issues, providing a scientific basis for optimizing the quality of CPR according to the needs of each patient in order to save more lives.REFERENCES
De Caen AR, Maconochie IK, Aickin R, Atkins DL, Biarent D, Guerguerian AM et al. Part 6: Pediatric basic life support and pediatric advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation. 2015; 132(16 Suppl 1): S177-S203.
Morrison LJ, Gent LM, Lang E, Nunnally ME, Parker MJ, Callaway CW et al. Part 2: Evidence evaluation and management of conflicts of interest: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2): S368-S382.
Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL et al. Part 11: Pediatric basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015; 132(18 Suppl 2): S519-S525.