Hilary Writer1. 1. Division of Paediatric Critical Care, University of Ottawa & Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Abstract
INTRODUCTION: Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children a year in resource-rich countries, with two thirds of arrests occurring in children under 18 months of age. Approximately 40% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 13 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: airway management and ventilation (bag-mask ventilation and intubation), bystander cardiopulmonary resuscitation, direct-current cardiac shock, hypothermia, intravenous sodium bicarbonate, standard dose of intravenous adrenaline (epinephrine), and training parents to perform resuscitation.
INTRODUCTION:Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children a year in resource-rich countries, with two thirds of arrests occurring in children under 18 months of age. Approximately 40% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 13 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: airway management and ventilation (bag-mask ventilation and intubation), bystander cardiopulmonary resuscitation, direct-current cardiac shock, hypothermia, intravenous sodium bicarbonate, standard dose of intravenous adrenaline (epinephrine), and training parents to perform resuscitation.
Authors: Brian J D'Cruz; Kristofer C Fertig; Anthony J Filiano; Shawn D Hicks; Donald B DeFranco; Clifton W Callaway Journal: J Cereb Blood Flow Metab Date: 2002-07 Impact factor: 6.200
Authors: Maria Beatriz M Perondi; Amelia G Reis; Edison F Paiva; Vinay M Nadkarni; Robert A Berg Journal: N Engl J Med Date: 2004-04-22 Impact factor: 91.245