Automated external defibrillator use in a previously healthy 31‐day‐old infant with out‐of‐hospital cardiac arrest due to ventricular fibrillation

Abstract

Introduction Current resuscitation guidelines state that the safety of automated external defibrillators (AEDs) in infants less than 1 year of age is unknown. Methods and Results We report successful AED use in a 31‐day‐old previously healthy infant with out‐of‐hospital cardiac arrest. Chest compressions began immediately, pediatric AED pads were applied in less than 5 minutes and the initial rhythm was ventricular fibrillation. After two 50 J shocks, return of spontaneous circulation was achieved. She was diagnosed with a rare but previously described syndrome of infant ventricular fibrillation and was discharged to home in good condition after epicardial defibrillator placement. Conclusions This case represents, to our knowledge, the youngest patient successfully defibrillated by an AED in a nonmedical setting. Although she received two shocks more than 11 J/kg each, she had no apparent myocardial damage at presentation.

Singapore Paediatric Resuscitation Guidelines 2021

“…There have been reported cases of safe and effective use of AEDs in infants and young children at an energy dose exceeding 4 J/kg. (38,39) Early defibrillation is the only effective therapy for pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF). We are unable to recommend the use of public access defibrillators for neonates owing to the extremely low incidence of shockable rhythms in the neonatal population and the lack of published validation on the accuracy of AEDs to analyse electrocardiographic algorithms in this age group.…”

Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

“…Es wurden eine Leitlinie [633], ein systematischer Review [634], eine Übersichtsarbeit [635] und 11 Beobachtungsstudien identifiziert (Anhang RR 22; [14,[636][637][638][639][640][641][642][643][644][645]…”