López-Herce Jesús, Rodríguez Núñez Antonio, Maconochie Ian, Van de Voorde Patric, Biarent Dominique, Eich Christof, Bingham Robert, Rajka Thomas, Zideman David, Carrillo Ángel, de Lucas Nieves, Calvo Custodio, Manrique Ignacio
Servicio de Cuidados Intensivos Pediátricos, Hospital Gregorio Marañón de Madrid. Facultad de Medicina. Universidad Complutense, Madrid, España.
Servicio Urgencias Pediátricas, Hospital Clínico Universitario de Santiago de Compostela, España.
Emergencias. 2017 Jul;29(4):266-281.
This summary of the European guidelines for pediatric cardiopulmonary resuscitation (CPR) emphasizes the main changes and encourages health care professionals to keep their pediatric CPR knowledge and skills up to date. Basic and advanced pediatric CPR follow the same algorithm in the 2015 guidelines. The main changes affect the prevention of cardiac arrest and the use of fluids. Fluid expansion should not be used routinely in children with fever in the abuse of signs of shock because too high a volume can worsen prognosis. Rescue breaths should last around 1 second in basic CPR, making pediatric recommendations consistent with those for adults. Chest compressions should be at least as deep as one-third the anteroposterior diameter of the thorax. Most children in cardiac arrest lack a shockable rhythm, and in such cases a coordinated sequence of breaths, chest compressions, and administration of adrenalin is essential. An intraosseous canula may be the first choice for introducing fluids and medications, especially in young infants. In treating supraventricular tachycardia with cardioversion, an initial dose of 1 J/kg is currently recommended (vs the dose of 0.5 J/kg previously recommended). After spontaneous circulation is recovered, measures to control fever should be taken. The goal is to reach a normal temperature even before arrival to the hospital.
本欧洲儿科心肺复苏（CPR）指南摘要强调了主要变化，并鼓励医护人员不断更新其儿科心肺复苏知识和技能。2015年指南中，基础和高级儿科心肺复苏遵循相同的算法。主要变化影响心脏骤停的预防和液体的使用。对于有发热且伴有休克迹象的儿童，不应常规使用液体扩容，因为液体量过高会使预后恶化。在基础心肺复苏中，人工呼吸应持续约1秒，使儿科建议与成人建议保持一致。胸外按压深度应至少达到胸廓前后径的三分之一。大多数心脏骤停的儿童没有可电击心律，在这种情况下，呼吸、胸外按压和肾上腺素给药的协调顺序至关重要。骨内插管可能是输注液体和药物的首选途径，尤其是在幼儿中。在通过心脏复律治疗室上性心动过速时，目前推荐初始剂量为1 J/kg（而之前推荐的剂量为0.5 J/kg）。自主循环恢复后，应采取控制发热的措施。目标是甚至在到达医院之前就使体温恢复正常。
