Cardiac Arrest in Children

Abstract

Perioperative cardiac arrest in children is a rare but catastrophic adverse event. It is difficult to investigate the incidence, risk factors, causes, and outcomes from these events, but the exercise is extremely useful in order to develop strategies to prevent it. Recent data identified several major risk factors for cardiac arrest in children: American Society of Anesthesiologists (ASA) physical status >3, age <1 year, and lack of specific pediatric experience by the healthcare providers. Since 1994, when the Perioperative Cardiac Arrest (POCA) Registry was created, the frequency of medicationrelated causes of cardiac arrest in children has decreased while the frequency of respiratory and cardiovascular causes has increased. The International Liaison Committee on Resuscitation Consensus Conference adopted the "5H+5T" acronym for the reversible causes of pediatric cardiac arrest: hypoxia, hypovolemia, hyper/hypokalemia, hypothermia, tension pneumothorax, cardiac tamponade, toxins, and cardiopulmonary thromboembolism. In this review article, the pathophysiology, diagnostic pathway, and treatment of perioperative cardiac arrest in children will be addressed. The importance of a certified training of anesthesiologists in pediatric advanced life support is also highlighted.