Download Resuscitation and Stabilization of the Critically Ill Child by Wheeler D., Wong H.R., Shanley T. PDF

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By Wheeler D., Wong H.R., Shanley T.

This ebook presents finished info on resuscitation and stabilization of a seriously unwell baby in a repackaging of the relavent chapters from the preferred Pediatric severe Care medication edited by way of Wheeler, Shanley and Wong.

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Although there are no published comparisons of antiarrhythmic medications for pediatric refractory VF, extrapolation of the adult studies has led to the recommendation of amiodarone as the preferred antiarrhythmic agent for children. Postresuscitation Interventions Temperature Management Mild induced hypothermia is the most celebrated goal-directed postresuscitation therapy for adults. Two seminal articles established that induced hypothermia (32°–34°C) could improve outcome for comatose adults after resuscitation from VF cardiac arrest [33,34].

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549–556. 28 35. Hilwig RW, Berg RA, Kern KB, et al. Endothelin-1 vasoconstriction during swine cardiopulmonary resuscitation improves coronary perfusion pressures but worsens postresuscitation outcome. Circulation 2000;101:2097–2102. 36. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960;173:1064–1067. 37. Berg RA, Hilwig RW, Kern KB, et al. Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest.

Prolonged CPR was continued until ECMO cannulas, circuits, and personnel were available. Six of these 11 children were longterm survivors without apparent neurologic sequelae [102]. Increasingly improved survival rates have been reported for pediatric cardiac patients provided with mechanical cardiopulmonary support within 20 min of the initiation of CPR. Despite these promising results, CPR and ECMO are not curative treatments; rather, they are simply cardiopulmonary supportive measures that may allow tissue perfusion and viability until recovery from the precipitating disease process can occur.

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