Epidemiology of Pediatric Cardiac Arrest

Rossano, Joseph W.; Naim, Maryam Y.; Berg, Robert A.

doi:10.1007/978-1-4471-4619-3_58

Cited by 2 publications

(2 citation statements)

References 74 publications

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“…In pediatric CA, asphyxia is the predominant mechanism, in contrast to adult CA where most cases result from ventricular fibrillation (VF). 1 In comparison with VF CA, the unique pathophysiology of asphyxial CA includes hypoxia, bradycardia, hypovolemia, and acidosis leading to different CBF disturbances post-CA, 35 and most likely, distinct alterations in cerebral microcirculation. Indeed, the CBF alterations observed in our model using ASL-MRI differ from the adult model of CA, especially at early time points after resuscitation, where cortical hyperemia is observed after adult CA.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 16,000 pediatric patients suffer from CA every year in the United States, accounting for up to one-quarter of all pediatric mortalities. 1 Thirty-five percent of the surviving patients at discharge have unfavorable neurological outcome. 2 To date, no pharmacological therapy has demonstrated neuroprotective benefit in the treatment of post-CA brain injury.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral microcirculatory alterations and the no-reflow phenomenon in vivo after experimental pediatric cardiac arrest

Poloyac

Watkins

et al. 2017

J Cereb Blood Flow Metab

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Decreased cerebral blood flow (CBF) after cardiac arrest (CA) contributes to secondary ischemic injury in infants and children. We previously reported cortical hypoperfusion with tissue hypoxia early in a pediatric rat model of asphyxial CA. In order to identify specific alterations as potential therapeutic targets to improve cortical hypoperfusion post-CA, we characterize the CBF alterations at the cortical microvascular level in vivo using multiphoton microscopy. We hypothesize that microvascular constriction and disturbances of capillary red blood cell (RBC) flow contribute to cortical hypoperfusion post-CA. After resuscitation from 9 min asphyxial CA, transient dilation of capillaries and venules at 5 min was followed by pial arteriolar constriction at 30 and 60 min (19.6 ± 1.3, 19.3 ± 1.2 µm at 30, 60 min vs. 22.0 ± 1.2 µm at baseline, p < 0.05). At the capillary level, microcirculatory disturbances were highly heterogeneous, with RBC stasis observed in 25.4% of capillaries at 30 min post-CA. Overall, the capillary plasma mean transit time was increased post-CA by 139.7 ± 51.5%, p < 0.05. In conclusion, pial arteriolar constriction, the no-reflow phenomenon and increased plasma transit time were observed post-CA. Our results detail the microvascular disturbances in a pediatric asphyxial CA model and provide a powerful platform for assessing specific vascular-targeted therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cerebral microcirculatory alterations and the no-reflow phenomenon in vivo after experimental pediatric cardiac arrest

Poloyac

Watkins

et al. 2017

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

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Implications of pediatric extracorporeal cardiopulmonary resuscitation simulation for intensive care team confidence and coordination: A pilot study

Akinpelu,

Shah,

Weaver

et al. 2023

Perfusion

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Introduction Extracorporeal cardiopulmonary resuscitation (ECPR) is associated with improved outcomes in select populations, however, crisis resource management (CRM) in this setting is logistically challenging. This study evaluates the impact of ECPR simulation on self-perceived confidence and collaboration of intensive care unit team members. Methods This is a prospective observational study analyzing data obtained between July 2018–December 2019. This study focused on non-surgical members of critical care team consisting of pediatric intensivists, resident physicians, registered nurses, respiratory therapists. Participants were expected to perform cardiopulmonary resuscitation (CPR) during the ECPR event, participate in code-team responsibilities and provide ancillary support during cannulation. Pre- and post-simulation surveys employed the Likert scale (1 = not at all confident, 5 = highly confident) to assess self-perceived scores in specified clinical competencies. Results Twenty-nine providers participated in the simulation; 38% had prior ECPR experience. Compared to mean pre-study Likert scores (2.4, 2.4, 2.5), post-simulation scores increased (4.2, 4.4, 4.3) when self-evaluating: confidence in assessing patients needing ECPR, confidence in participating in ECPR workflow and confidence in performing high-quality CPR, respectively. Post-simulation values of >3 were reported by 100% of participants in all domains ( p < .0001). All participants indicated the clinical scenario and procedural environment to be realistic and appropriately reflective of situational stress. Additionally, 100% of participants reported the simulation to improve perceived team communication and teamwork skills. Conclusion This study demonstrated preliminary feasibility of pediatric ECPR simulation in enhancing independent provider confidence and team communication. This self-perceived improvement may establish a foundation for cohesive CRM, in preparation for a real life ECPR encounter.

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Epidemiology of Pediatric Cardiac Arrest

Cited by 2 publications

References 74 publications

Cerebral microcirculatory alterations and the no-reflow phenomenon in vivo after experimental pediatric cardiac arrest

Cerebral microcirculatory alterations and the no-reflow phenomenon in vivo after experimental pediatric cardiac arrest

Implications of pediatric extracorporeal cardiopulmonary resuscitation simulation for intensive care team confidence and coordination: A pilot study

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