Circulation. 2019 Aug 6;140(6):e194-e233. doi: 10.1161/CIR.0000000000000697. Epub 2019 Jun 27.
Successful resuscitation from cardiac arrest results in a post-cardiac arrest syndrome, which can evolve in the days to weeks after return of sustained circulation. The components of post-cardiac arrest syndrome are brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathophysiology. Pediatric post-cardiac arrest care focuses on anticipating, identifying, and treating this complex physiology to improve survival and neurological outcomes. This scientific statement on post-cardiac arrest care is the result of a consensus process that included pediatric and adult emergency medicine, critical care, cardiac critical care, cardiology, neurology, and nursing specialists who analyzed the past 20 years of pediatric cardiac arrest, adult cardiac arrest, and pediatric critical illness peer-reviewed published literature. The statement summarizes the epidemiology, pathophysiology, management, and prognostication after return of sustained circulation after cardiac arrest, and it provides consensus on the current evidence supporting elements of pediatric post-cardiac arrest care.
成功的心脏骤停复苏会导致心搏骤停后综合征,这种综合征可能在自主循环恢复后的数天至数周内发展。心搏骤停后综合征的组成部分包括脑损伤、心肌功能障碍、全身缺血/再灌注反应和持续的促发病理生理学。儿科心搏骤停后护理的重点是预测、识别和治疗这种复杂的生理状况,以提高生存率和神经功能预后。本关于心搏骤停后护理的科学声明是一个共识过程的结果,该过程包括儿科和成人急诊医学、重症监护、心脏重症监护、心脏病学、神经病学和护理专家,他们分析了过去 20 年的儿科心搏骤停、成人心搏骤停和儿科危重病的同行评议发表文献。该声明总结了心搏骤停后自主循环恢复后的流行病学、病理生理学、管理和预后,并就支持儿科心搏骤停后护理各个方面的当前证据达成了共识。