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What role does defibrillation play in pediatric resuscitation?
Historically, pediatric resuscitation has focused on pulmonary causes; defibrillation is a relatively uncommon intervention in pediatric resuscitation. Although asystole remains the most commonly observed arrhythmia during pediatric cardiac arrests, recent research indicates that VF may occur much more frequently than originally thought. The National Registry of Cardiopulmonary Resuscitation, the largest inpatient pediatric cohort reported to date, found VF occurred in 14% of pediatric arrests. In that study, pediatric patients with VF had a higher survival rate (29%) than those with asystole (24%) or PEA (11%). A study of out-of-hospital pediatric arrests found VF as the presenting rhythm in 17.6% of cases, with children older than 7 years of age having the highest incidence (38/141, 27.0%). Survival of patients with VF was threefold greater (31.3% versus 10.7%) than in those without a shockable rhythm.
Sources
Smith BT, Rea TD, Eisenberg MS: Ventricular fibrillation in pediatric cardiac arrest. Acad Emerg Med 2006;13:525-529.
