2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 7. Pediatric advanced life support

Abstract

The 2020 Korean pediatric cardiopulmonary resuscitation (CPR) guidelines refer to the medical recommendations derived from the scientific evidence for pediatric advanced life support (PALS). These guidelines are based on the scientific consensus and treatment recommendations made in 2020 by the International Liaison Committee on Resuscitation, which establishes the CPR guideline. Studies published on PALS were considered in formulating it. 1 Evidence for the revised items that is of high clinical importance and requires additional consideration was reviewed in an acceptable adaptation or hybrid format, and a meta-analysis or scoping review was done. MAJOR CHANGES IN THE 2020 PALS GUIDELINESWhen compared with the 2015 guideline, 2 the changes in the 2020 PALS guidelines are as follows. Defibrillation energy doseThe first defibrillator dose of 2 J/kg is recommended for shockable rhythms in pediatric cardiac arrest (Class I, Level B-NR).

Comparison of paediatric basic life support guidelines endorsed by member councils of Resuscitation Council of Asia

“…A summary review of the latest selected basic and advanced paediatric life support guidelines of these resuscitation councils were reported in Table 2 , Table 3 , respectively. 3 , 5 , 6 , 7 , 8 The previous guidelines for basic and advanced paediatric life support guidelines were reported in Supplementary Tables S1 and S2 , respectively. 12 , 13 , 14 , 15 , 16 , 17 …”

“…Examples of which would include paediatric chest compression depth targets, ventilation rates post advanced airway placement intra-arrest and initial defibrillation dose for paediatric cardiac arrest with shockable rhythms. 2 , 3 , 4 , 5 , 6 , 7 , 8 …”

“…The recommendation of ventilation rate of 10 per minute post advanced airway placement during paediatric cardiac arrest was solely extrapolated from adult observational studies and animal studies. 2 , 3 , 4 , 5 , 6 , 7 , 8 A small observational paediatric study suggested that ventilation rates of at least 30 per minute in infants, and 25 per minute in children were associated with improved survival. 29 Thus, AHA changed their guidelines for ventilation rates post advanced airway placement intra-arrest.…”

“… 1 These treatment recommendations based on expert consensus and scientific literature are reviewed by resuscitation councils worldwide for their resuscitation guidelines. 2 , 3 , 4 , 5 , 6 , 7 , 8 …”

National Surveillance of Pediatric Out-of-Hospital Cardiac Arrest in Korea: The 10-Year Trend From 2009 to 2018

“… 35 The poorer prognosis of group 1 might be because children younger than 1 year have less physiological reserve and increased vulnerability to cardiac arrest compared with older children. 36 37 …”