Circulation. 2018 May 29;137(22):e691-e782. doi: 10.1161/CIR.0000000000000524. Epub 2018 Apr 23.
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. The recommendations in this statement concur with the critical components of the 2015 American Heart Association pediatric basic life support and pediatric advanced life support guidelines and are meant to serve as a resuscitation supplement. This statement is meant for caregivers of children with heart disease in the prehospital and in-hospital settings. Understanding the anatomy and physiology of the high-risk pediatric cardiac population will promote early recognition and treatment of decompensation to prevent cardiac arrest, increase survival from cardiac arrest by providing high-quality resuscitations, and improve outcomes with postresuscitation care.
心脏病患儿的心脏骤停发生率高于健康儿童。儿科基础生命支持和高级生命支持指南的重点是为正常心脏的儿童提供高质量的复苏。儿科心脏病的复杂性和可变性在复苏过程中带来了独特的挑战。美国心脏协会任命的一个写作小组审查了涉及心脏病患儿复苏的文献。从 1966 年到 2015 年,在 MEDLINE 和 Google Scholar 数据库中搜索了与儿科心脏病相关的复苏检索词,并进行了交叉参考。美国心脏病学会/美国心脏协会实践指南的推荐分类和证据水平被用于本研究。本声明中的建议与 2015 年美国心脏协会儿科基础生命支持和儿科高级生命支持指南的关键内容一致,旨在作为复苏补充。本声明适用于院前和院内有心脏病儿童的护理人员。了解高危儿科心脏人群的解剖和生理学将有助于早期识别和治疗失代偿,以预防心脏骤停,通过提供高质量的复苏来提高心脏骤停后的生存率,并改善复苏后的护理结果。