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dc.contributor.authorRodríguez-Núñez, Antonio
dc.contributor.authorLópez-Herce Cid, Jesús
dc.contributor.authorGarcía, Cristina
dc.contributor.authorDomínguez Sampedro, Pedro
dc.contributor.authorCarrillo, Ángel
dc.contributor.authorBellón Cano, José María
dc.date.accessioned2010-09-14T12:12:53Z
dc.date.available2010-09-14T12:12:53Z
dc.date.issued2006
dc.identifier.bibliographicCitationCritical Care, 2006, v. 10, n. 4, R113en
dc.identifier.issn1364-8535
dc.identifier.urihttp://hdl.handle.net/10017/6720
dc.description.abstractIntroduction 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 children. Methods Forty-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 oneyear survival. Characteristics of patients and of resuscitation were evaluated. Results 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. Conclusion 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 onethird 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.en
dc.description.sponsorshipThis study was supported by a Grant from the Fondo de Investigaciones Sanitarias, 00/0288.en
dc.format.mimetypeapplication/pdfen
dc.language.isoengen
dc.publisherBioMed Centralen
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 Españaes_ES
dc.rights(c) BioMed Central, 2006en
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
dc.subjectPediatric defibrillationen
dc.subjectCardiac arresten
dc.titlePediatric defibrillation after cardiac arrest: Initial response and outcomeen
dc.typeinfo:eu-repo/semantics/articleen
dc.subject.ecienciaCirugíaes_ES
dc.subject.ecienciaSurgeryen
dc.subject.ecienciaCiencias de la saludes_ES
dc.subject.ecienciaHealth sciencesen
dc.contributor.affiliationUniversidad de Alcalá. Departamento de Cirugía, Ciencias Médicas y Socialeses_ES
dc.relation.publisherversionhttp://dx.doi.org/10.1186/cc5005
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
dc.identifier.doi10.1186/cc5005
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessen


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