Automated external defibrillators for children: what is new?

Although automated external defibrillators (AEDs) have been available for adults for more than 20 years, their use in children under 8 years of age has been approved by the International Liaison Committee on Resuscitation (ILCOR) as recently as June 2003. The following concerns about AEDs limited their use in children: amount of delivered energy, effect of biphasic waveforms in children, pad size, and capacity of detecting pediatric shockable and non-shockable rhythms. Lately, a new generation of AEDs addressed these issues and new encouraging data are available. New AEDs safely identify pediatric shockable and non-shockable rhythms and deliver fixed lower energy shocks through pads of appropriate size. This perspective briefly describes the main advances which heralded the new recommendations of ILCOR. Randomized clinical trials are now needed to identify whether these new pediatric devices can improve the outcome of pediatric cardiac arrest.