Pediatrics. 2021 Jan;147(Suppl 1). doi: 10.1542/peds.2020-038505B. Epub 2020 Oct 21.
This (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation.Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.
这份儿科生命支持共识指南(CoSTR)是基于儿科生命支持专家组进行的最广泛的证据评估。在本次综述中使用了三种证据评估类型:系统评价、范围综述和证据更新。根据复苏国际联络委员会的证据评估建议,只有系统评价才能产生新的或修订的治疗建议。为本次 2020 年儿科生命支持 CoSTR 进行的系统评价包括在提供儿科基础生命支持时,气道-呼吸-按压的顺序与按压-气道-呼吸的顺序、肾上腺素复苏时给药的初始时机和剂量间隔,以及自主循环恢复后儿科患者的氧气和二氧化碳水平的目标。最具争议的话题包括肾上腺素给药的初始时机和剂量间隔(提出了新的治疗建议),以及脓毒性休克婴儿和儿童的液体给药(后一个话题通过证据更新进行了评估)。所有证据综述都指出了儿科数据的缺乏,以及需要更多涉及婴儿和儿童复苏的研究。