Pediatric Cardiology

, Volume 33, Issue 3, pp 474–483 | Cite as

Improving Outcomes from Out-of-Hospital Cardiac Arrest in Young Children and Adolescents

Review Article


Out-of-hospital cardiac arrest (OHCA) is an unusual but devastating occurrence in a young person. Years of life-lost are substantial and long-term health care costs of survivors can be high. However, there have been noteworthy improvements in cardiopulmonary resuscitation (CPR) standards, out-of hospital care, and postcardiac arrest therapies that have resulted in a several-fold improvement in resuscitation outcomes. Recent interest and research in resuscitation of children has the promise of generating improvements in the outcomes of these patients. Integrated and coordinated care in the out-of-hospital and hospital settings are required. This article will review the epidemiology of OHCA, the 2010 CPR guidelines, and developments in public access defibrillation for children.


Cardiopulmonary resuscitation Cardiac arrest Outcomes 


  1. 1.
    Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O’Hearn N, Vanden Hoek TL, Becker LB (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293:305–310PubMedCrossRefGoogle Scholar
  2. 2.
    Abella BS, Sandbo N, Vassilatos P, Alvarado JP, O’Hearn N, Wigder HN, Hoffman P, Tynus K, Vanden Hoek TL, Becker LB (2005) Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest. Circulation 111:428–434PubMedCrossRefGoogle Scholar
  3. 3.
    Agarwal DA, Hess EP, Atkinson EJ, White RD (2009) Ventricular fibrillation in Rochester, Minnesota: experience over 18 years. Resuscitation 80:1253–1258Google Scholar
  4. 4.
    American Heart Association (2005) 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 112:IV1–IV203Google Scholar
  5. 5.
    Atkins DL (2009) Public access defibrillation: where does it work? Circulation 120:461–463PubMedCrossRefGoogle Scholar
  6. 6.
    Atkins DL, Everson-Stewart S, Sears GK, Daya M, Osmond MH, Warden CR, Berg RA, Investigators R (2009) Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the Resusctation Outcomes Consortium Epistry-Cardiac Arrest. Circulation 119:1484–1491PubMedCrossRefGoogle Scholar
  7. 7.
    Aufderheide T (2004) Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med 32:S345–S351PubMedCrossRefGoogle Scholar
  8. 8.
    Aufderheide T (2004) Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation 109:1960–1965Google Scholar
  9. 9.
    Barrett CS, Bratton SL, Salvin JW, Laussen PC, Rycus PT, Thiagarajan RR (2009) Neurological injury after extracorporeal membrane oxygenation use to aid pediatric cardiopulmonary resuscitation. Pediatr Crit Care Med 10:445–451PubMedCrossRefGoogle Scholar
  10. 10.
    Becker L, Eisenberg M, Fahrenbruch C, Cobb L (1998) Public locations of cardiac arrest: implications for public access defibrillation. Circulation 97:2106–2109PubMedGoogle Scholar
  11. 11.
    Berg RA, Hilwig RW, Kern KB, Babar I, Ewy GA (1999) Simulated mouth-to-mouth ventilation and chest compressions (bystander cardiopulmonary resuscitation) improves outcome in a swine model of prehospital pediatric asphyxial cardiac arrest. Crit Care Med 27:1893–1899PubMedCrossRefGoogle Scholar
  12. 12.
    Berg RA, Hilwig RW, Kern KB, Ewy GA (2000) Bystander” chest compressions and assisted ventilation independently improve outcome from piglet asphyxial pulseless “cardiac arrest. Circulation 101:1743–1748PubMedGoogle Scholar
  13. 13.
    Berg MD, Schexnayder SM, Chameides L, Terry M, Donoghue A, Hickey RW, Berg RA, Sutton RM, Hazinski MF (2010) Part 13: Pediatric basic life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S862–S875PubMedCrossRefGoogle Scholar
  14. 14.
    Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, Smith K (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 346:557–563PubMedCrossRefGoogle Scholar
  15. 15.
    Bhende MS, Allen WD Jr (2002) Evaluation of a Capno-Flo resuscitator during transport of critically ill children. Pediatr Emerg Care 18:414–416PubMedCrossRefGoogle Scholar
  16. 16.
    Blewer AL, Leary M, Decker CS, Andersen JC, Fredericks AC, Bobrow BJ, Abella BS (2010) Cardiopulmonary resuscitation training of family members before hospital discharge using video self-instruction: a feasibility trial. J Hosp Med (Epub ahead of print)Google Scholar
  17. 17.
    Bobrow BJ, Vadeboncoeur TF, Spaite DW, Potts J, Denninghoff K, Chikani V, Brazil PR, Ramsey B, Abella BS (2011) The effectiveness of ultrabrief and brief educational videos for training lay responders in hands-only cardiopulmonary resuscitation: implications for the future of citizen cardiopulmonary resuscitation training. Circ Cardiovasc Qual Outcomes 4:220–226PubMedCrossRefGoogle Scholar
  18. 18.
    Buunk G, van der Hoeven JG, Meinders AE (1997) Cerebrovascular reactivity in comatose patients resuscitated from a cardiac arrest. Stroke 28:1569–1573PubMedCrossRefGoogle Scholar
  19. 19.
    Cave DM, Aufderheide TP, Beeson J, Ellison A, Gregory A, Hazinski MF, Hiratzka LF, Lurie KG, Morrison LJ, Mosesso VN Jr, Nadkarni V, Potts J, Samson RA, Sayre MR, Schexnayder SM (2011) Importance and implementation of training in cardiopulmonary resuscitation and automated external defibrillation in schools: a science advisory from the American Heart Association. Circulation 123:691–706PubMedCrossRefGoogle Scholar
  20. 20.
    Chameides L (1987) Cardiopulmonary resuscitation: standards, guidelines, and education. Pediatrics 79:446–449PubMedGoogle Scholar
  21. 21.
    Chan T, Thiagarajan RR, Frank D, Bratton SL (2008) Survival after extracorporeal cardiopulmonary resuscitation in infants and children with heart disease. J Thorac Cardiovasc Surg 136:984–992PubMedCrossRefGoogle Scholar
  22. 22.
    Chow G, Koirala B, Armstrong D, McCrindle B, Bohn D, Edgell D, Coles J, de Veber G (2004) Predictors of mortality and neurological morbidity in children undergoing extracorporeal life support for cardiac disease. Eur J Cardiothorac Surg 26:38–43PubMedCrossRefGoogle Scholar
  23. 23.
    De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL (2010) Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med 362:779–789PubMedCrossRefGoogle Scholar
  24. 24.
    Deasy C, Bernard SA, Cameron P, Jaison A, Smith K, Harriss L, Walker T, Masci K, Tibballs J (2010) Epidemiology of paediatric out-of-hospital cardiac arrest in Melbourne, Australia. Resuscitation 81:1095–1100PubMedCrossRefGoogle Scholar
  25. 25.
    Donoghue AJ, Nadkarni V, Berg RA, Osmond MH, Wells G, Nesbitt L, Stiell IG (2005) Out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge. Ann Emerg Med 46:512–522PubMedCrossRefGoogle Scholar
  26. 26.
    Drezner JA, Rao AL, Heistanc J, Bloomingdale MK, Harmon KG (2009) Effectiveness of emergency response planning for sudden cardiac arrest in United States high schools with automated external defibbrillators. Circulation 120:518–525PubMedCrossRefGoogle Scholar
  27. 27.
    England H, Hoffman C, Hodgman T, Singh S, Homoud M, Weinstock J, Link M, Estes NA 3rd (2005) Effectiveness of automated external defibrillators in high schools in greater Boston. Am J Cardiol 95:1484–1486PubMedCrossRefGoogle Scholar
  28. 28.
    Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, Samson RA, Kattwinkel J, Berg RA, Bhanji F, Cave DM, Jauch EC, Kudenchuk PJ, Neumar RW, Peberdy MA, Perlman JM, Sinz E, Travers AH, Berg MD, Billi JE, Eigel B, Hickey RW, Kleinman ME, Link MS, Morrison LJ, O’Connor RE, Shuster M, Callaway CW, Cucchiara B, Ferguson JD, Rea TD, Vanden Hoek TL (2010) Part 1: Executive summary: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S640–S656PubMedCrossRefGoogle Scholar
  29. 29.
    Ghez O, Feier H, Ughetto F, Fraisse A, Kreitmann B, Metras D (2005) Postoperative extracorporeal life support in pediatric cardiac surgery: recent results. ASAIO J 51:513–516PubMedCrossRefGoogle Scholar
  30. 30.
    Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM, Polin RA, Robertson CM, Thoresen M, Whitelaw A, Gunn AJ (2005) Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet 365:663–670PubMedGoogle Scholar
  31. 31.
    Group HACaS (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 346:549–556CrossRefGoogle Scholar
  32. 32.
    Gundry JW, Comess KA, DeRook FA, Jorgenson D, Bardy GH (1999) Comparison of naive sixth-grade children with trained professionals in the use of an automated external defibrillator. Circulation 100:1703–1707PubMedGoogle Scholar
  33. 33.
    Hallstrom AP, Ornato JP, Weisfeldt M, Travers A, Christenson J, McBurnie MA, Zalenski R, Becker LB, Schron EB, Proschan M, Public Access Defibrillation Trial I (2004) Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 351:637–646PubMedCrossRefGoogle Scholar
  34. 34.
    Hazinski MF, Markenson DS, Neish SR, Gerardi MJ, Hootman J, Nichol G, Taras H, Hickey RW, O’Connor R, Potts J, van der Jagt E, Berger S, Schexnayder S, Garson A, Doherty A, Smith SA (2004) Response to cardic arrest and selected life-threatening medical emergencies: the medical emergency response plan for schools. A statement of healthcare providers, policymakers, school administrators, and community leaders. Pediatrics 113:155–168PubMedCrossRefGoogle Scholar
  35. 35.
    Hazinski MF, Nolan JP, Billi JE, Bottiger BW, Bossaert L, de Caen AR, Deakin CD, Drajer S, Eigel B, Hickey RW, Jacobs I, Kleinman ME, Kloeck W, Koster RW, Lim SH, Mancini ME, Montgomery WH, Morley PT, Morrison LJ, Nadkarni VM, O’Connor RE, Okada K, Perlman JM, Sayre MR, Shuster M, Soar J, Sunde K, Travers AH, Wyllie J, Zideman D (2010) Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation 122:S250–S275PubMedCrossRefGoogle Scholar
  36. 36.
    Hickey RW (2006) Response to: out-of-hospital pediatric cardiac arrest: an epidemiologic review and assessment of current knowledge. Ann Emerg Med 48:219PubMedCrossRefGoogle Scholar
  37. 37.
    Hickey RW, Cohen DM, Strausbaugh S, Dietrich AM (1995) Pediatric patients requiring CPR in the prehospital setting. Ann Emerg Med 25:495–501PubMedCrossRefGoogle Scholar
  38. 38.
    Hinchey PR, Myers JB, Lewis R, De Maio VJ, Reyer E, Licatese D, Zalkin J, Snyder G (2010) Improved out-of-hospital cardiac arrest survival after the sequential implementation of 2005 AHA guidelines for compressions, ventilations, and induced hypothermia: the Wake County experience. Ann Emerg Med 56:348–357PubMedCrossRefGoogle Scholar
  39. 39.
    Hoffman TM, Wernovsky G, Atz AM, Bailey JM, Akbary A, Kocsis JF, Nelson DP, Chang AC, Kulik TJ, Spray TL, Wessel DL (2002) Prophylactic intravenous use of milrinone after cardiac operation in pediatrics (PRIMACORP) study. Prophylactic intravenous use of milrinone after cardiac operation in pediatrics. Am Heart J 143:15–21PubMedCrossRefGoogle Scholar
  40. 40.
    Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, Bailey JM, Akbary A, Kocsis JF, Kaczmarek R, Spray TL, Wessel DL (2003) Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 107:996–1002PubMedCrossRefGoogle Scholar
  41. 41.
    Isbye DL, Rasmussen LS, Lippert FK, Rudolph SF, Ringsted CV (2006) Laypersons may learn basic life support in 24 min using a personal resuscitation manikin. Resuscitation 69:435–442PubMedCrossRefGoogle Scholar
  42. 42.
    Isbye DL, Rasmussen LS, Ringsted C, Lippert FK (2007) Disseminating cardiopulmonary resuscitation training by distributing 35,000 personal manikins among school children. Circulation 116:1380–1385PubMedCrossRefGoogle Scholar
  43. 43.
    Jones I, Whitfield R, Colquhoun M, Chamberlain D, Vetter N, Newcombe R (2007) At what age can schoolchildren provide effective chest compressions? An observational study from the Heartstart UK schools training programme. Br Med J 334:1201CrossRefGoogle Scholar
  44. 44.
    Kelley JR, Richman PB, Ewy GA, Clark L, Bulloch B, Bobrow BJ (2006) Eighth grade students become proficient at CPR and use of an AED following a condensed training programme. Resuscitation 71:229–236PubMedCrossRefGoogle Scholar
  45. 45.
    Kern KB, Hilwig RW, Berg RA, Rhee KH, Sanders AB, Otto CW, Ewy GA (1997) Postresuscitation left ventricular systolic and diastolic dysfunction. Treatment with dobutamine. Circulation 95:2610–2613PubMedGoogle Scholar
  46. 46.
    Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM, Berg RA, Hiraide A (2010) Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. Lancet 375:1347–1354PubMedCrossRefGoogle Scholar
  47. 47.
    Kleinman ME, Chameides L, Schexnayder SM, Samson RA, Hazinski MF, Atkins DL, Berg MD, de Caen AR, Fink EL, Freid EB, Hickey RW, Marino BS, Nadkarni VM, Proctor LT, Qureshi FA, Sartorelli K, Topjian A, van der Jagt EW, Zaritsky AL (2010) Pediatric advanced life support: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics 126:e1361–e1399PubMedCrossRefGoogle Scholar
  48. 48.
    Kleinman ME, de Caen AR, Chameides L, Atkins DL, Berg RA, Berg MD, Bhanji F, Biarent D, Bingham R, Coovadia AH, Hazinski MF, Hickey RW, Nadkarni VM, Reis AG, Rodriguez-Nunez A, Tibballs J, Zaritsky AL, Zideman D (2010) Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation 122:S466–S515PubMedCrossRefGoogle Scholar
  49. 49.
    Kuisma M, Alaspää A (1997) Out-of-hospital cardiac arrests of non-cardiac origin: epidemiology and outcome. Eur Heart J 18:1122–1128PubMedGoogle Scholar
  50. 50.
    Langhelle A, Tyvold SS, Lexow K, Hapnes SA, Sunde K, Steen PA (2003) In-hospital factors associated with improved outcome after out-of-hospital cardiac arrest. A comparison between four regions in Norway. Resuscitation 56:247–263PubMedCrossRefGoogle Scholar
  51. 51.
    Laver SR, Padkin A, Atalla A, Nolan JP (2006) Therapeutic hypothermia after cardiac arrest: a survey of practice in intensive care units in the United Kingdom. Anaesthesia 61:873–877PubMedCrossRefGoogle Scholar
  52. 52.
    Lawson L, March J (2002) Automated external defibrillation by very young, untrained children. Prehosp Emerg Care 6:295–298PubMedCrossRefGoogle Scholar
  53. 53.
    Lequier L, Joffe AR, Robertson CM, Dinu IA, Wongswadiwat Y, Anton NR, Ross DB, Rebeyka IM (2008) Two-year survival, mental, and motor outcomes after cardiac extracorporeal life support at less than five years of age. J Thorac Cardiovasc Surg 136:976–983PubMedCrossRefGoogle Scholar
  54. 54.
    Lopez-Herce J, Garcia C, Dominguez P, Carrillo A, Rodriguez-Nunez A, Calvo C, Delgado MA (2004) Characteristics and outcome of cardiorespiratory arrest in children. Resuscitation 63:311–320PubMedCrossRefGoogle Scholar
  55. 55.
    Lopez-Herce J, Garcia C, Dominguez P, Rodriguez-Nunez A, Carrillo A, Calvo C, Delgado MA (2005) Outcome of out-of-hospital cardiorespiratory arrest in children. Pediatr Emerg Care 21:807–815PubMedCrossRefGoogle Scholar
  56. 56.
    Lopez-Herce J, Garcia C, Rodriguez-Nunez A, Dominguez P, Carrillo A, Calvo C, Delgado MA (2005) Long-term outcome of paediatric cardiorespiratory arrest in Spain. Resuscitation 64:79–85PubMedCrossRefGoogle Scholar
  57. 57.
    Lorem T, Palm A, Wik L (2008) Impact of a self-instruction CPR kit on 7th graders’ and adults’ skills and CPR performance. Resuscitation 79:103–108PubMedCrossRefGoogle Scholar
  58. 58.
    Lorem T, Steen PA, Wik L (2010) High school students as ambassadors of CPR: a model for reaching the most appropriate target population? Resuscitation 81:78–81PubMedCrossRefGoogle Scholar
  59. 59.
    Lotfi K, White L, Rea T, Cobb L, Copass M, Yin L, Becker L, Eisenberg M (2007) Cardiac arrest in schools. Circulation 116:1374–1379PubMedCrossRefGoogle Scholar
  60. 60.
    Meyer RJ, Kern KB, Berg RA, Hilwig RW, Ewy GA (2002) Post-resuscitation right ventricular dysfunction: delineation and treatment with dobutamine. Resuscitation 55:187–191PubMedCrossRefGoogle Scholar
  61. 61.
    Morris MC, Ittenbach RF, Godinez RI, Portnoy JD, Tabbutt S, Hanna BD, Hoffman TM, Gaynor JW, Connelly JT, Helfaer MA, Spray TL, Wernovsky G (2004) Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation. Crit Care Med 32:1061–1069PubMedCrossRefGoogle Scholar
  62. 62.
    Morris MC, Wernovsky G, Nadkarni VM (2004) Survival outcomes after extracorporeal cardiopulmonary resuscitation instituted during active chest compressions following refractory in-hospital pediatric cardiac arrest. Pediatr Crit Care Med 5:440–446PubMedCrossRefGoogle Scholar
  63. 63.
    Mosesso VN Jr, Shapiro AH, Stein K, Burkett K, Wang H (2009) Effects of AED device features on performance by untrained laypersons. Resuscitation 80:1285–1289PubMedCrossRefGoogle Scholar
  64. 64.
    Nichol G, Thomas E, Callaway CW, Hedges J, Powell JL, Aufderheide TP, Rea T, Lowe R, Brown T, Dreyer J, Davis D, Idris A, Stiell I (2008) Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA 300:1423–1431PubMedCrossRefGoogle Scholar
  65. 65.
    Nolan JP, Laver SR, Welch CA, Harrison DA, Gupta V, Rowan K (2007) Outcome following admission to UK intensive care units after cardiac arrest: a secondary analysis of the ICNARC Case Mix Programme Database. Anaesthesia 62:1207–1216PubMedCrossRefGoogle Scholar
  66. 66.
    Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M, Gabrielli A, Silvers SM, Zaritsky AL, Merchant R, Vanden Hoek TL, Kronick SL (2010) Part 9: Post-cardiac arrest care: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S768–S786PubMedCrossRefGoogle Scholar
  67. 67.
    Pierick TA, Van Waning N, Patel S, Atkins DL (2010) Infant CPRAnytime: self-instructional CPR training for parents of high-risk infants. Circulation 122:A12388Google Scholar
  68. 68.
    Potts J, Lynch B (2006) The American Heart Association CPR Anytime Program: the potential impact of highly accessible training in cardiopulmonary resuscitation. J Cardiopulm Rehabil 26:346–354PubMedCrossRefGoogle Scholar
  69. 69.
    Rea TD, Eisenberg MS (2003) Long-term survival after resuscitation from cardiac arrest: cause for optimism and continued efforts. Am Heart J 145:749–750PubMedCrossRefGoogle Scholar
  70. 70.
    Rea TD, Eisenberg MS, Sinibaldi G, White RD (2004) Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation 63:17–24PubMedCrossRefGoogle Scholar
  71. 71.
    Rea TD, Pearce RM, Raghunathan TE, Lemaitre RN, Sotoodehnia N, Jouven X, Siscovick DS (2004) Incidence of out-of-hospital cardiac arrest. Am J Cardiol 93:1455–1460PubMedCrossRefGoogle Scholar
  72. 72.
    Rea TD, Helbock M, Perry S, Garcia M, Cloyd D, Becker L, Eisenberg M (2006) Increasing use of cardiopulmonary resuscitation during out-of-hospital ventricular fibrillation arrest: survival implications of guideline changes. Circulation 114:2760–2765PubMedCrossRefGoogle Scholar
  73. 73.
    Rodriguez-Nunez A, Lopez-Herce J, Garcia C, Dominguez P, Carrillo A, Bellon JM (2006) Pediatric defibrillation after cardiac arrest: initial response and outcome. Crit Care 10:R113PubMedCrossRefGoogle Scholar
  74. 74.
    Roppolo LP, Pepe PE, Campbell L, Ohman K, Kulkarni H, Miller RA, Idris A, Bean L, Bettes TN, Idris AH (2007) Prospective, randomized trial of the effectiveness and retention of 30-min layperson training for cardiopulmonary resuscitation and automated external defibrillators: The American Airlines Study. Resuscitation 74:276–285PubMedCrossRefGoogle Scholar
  75. 75.
    Roppolo LP, Saunders T, Pepe PE, Idris AH (2007) Layperson training for cardiopulmonary resuscitation: when less is better. Curr Opin Crit Care 13:256–260PubMedCrossRefGoogle Scholar
  76. 76.
    Rothmier JD, Drezner JA, Harmon KG (2007) Automated external defibrillators in Washington State high schools. Br J Sports Med 41:301–305PubMedCrossRefGoogle Scholar
  77. 77.
    Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD (2008) Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee. Circulation 117:2162–2167PubMedCrossRefGoogle Scholar
  78. 78.
    Seethala RR, Esposito EC, Abella BS (2010) Approaches to improving cardiac arrest resuscitation performance. Curr Opin Crit Care 16:196–202PubMedCrossRefGoogle Scholar
  79. 79.
    Shankaran S, Laptook AR, Ehrenkranz RA, Tyson JE, McDonald SA, Donovan EF, Fanaroff AA, Poole WK, Wright LL, Higgins RD, Finer NN, Carlo WA, Duara S, Oh W, Cotten CM, Stevenson DK, Stoll BJ, Lemons JA, Guillet R, Jobe AH (2005) Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy. N Engl J Med 353:1574–1584PubMedCrossRefGoogle Scholar
  80. 80.
    Shankaran S, Pappas A, Laptook AR, McDonald SA, Ehrenkranz RA, Tyson JE, Walsh M, Goldberg RN, Higgins RD, Das A (2008) Outcomes of safety and effectiveness in a multicenter randomized, controlled trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy. Pediatrics 122:e791–e798PubMedCrossRefGoogle Scholar
  81. 81.
    Singh S, Allen WD Jr, Venkataraman ST, Bhende MS (2006) Utility of a novel quantitative handheld microstream capnometer during transport of critically ill children. Am J Emerg Med 24:302–307PubMedCrossRefGoogle Scholar
  82. 82.
    Sirbaugh PE, Pepe PE, Shook JE, Kimball KT, Goldman MJ, Ward MA, Mann DA (1999) A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest. Ann Emerg Med 33:174–184PubMedCrossRefGoogle Scholar
  83. 83.
    Thiagarajan RR, Laussen PC, Rycus PT, Bartlett RH, Bratton SL (2007) Extracorporeal membrane oxygenation to aid cardiopulmonary resuscitation in infants and children. Circulation 116:1693–1700PubMedCrossRefGoogle Scholar
  84. 84.
    Travers AH, Rea TD, Bobrow BJ, Edelson DP, Berg RA, Sayre MR, Berg MD, Chameides L, O’Connor RE, Swor RA (2010) Part 4: CPR overview: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 122:S676–S684PubMedCrossRefGoogle Scholar
  85. 85.
    Yannopoulos D, McKnite S, Aufderheide TP, Sigurdsson G, Pirrallo RG, Benditt D, Lurie KG (2005) Effects of incomplete chest wall decompression during cardiopulmonary resuscitation on coronary and cerebral perfusion pressures in a porcine model of cardiac arrest. Resuscitation 64:363–372PubMedCrossRefGoogle Scholar
  86. 86.
    Young KD, Seidel JS (1999) Pediatric cardiopulmonary resuscitation: a collective review. Ann Emerg Med 33:195–205PubMedCrossRefGoogle Scholar
  87. 87.
    Young KD, Gausche-Hill M, McClung CD, Lewis RJ (2004) A prospective, population-based study of the epidemiology and outcome of out-of-hospital pediatric cardiopulmonary arrest. Pediatrics 114:157–164PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Carver College of MedicineUniversity of Iowa Children’s HospitalIowa CityUSA
  2. 2.Children’s Hospital of Wisconsin, Medical College of WisconsinMilwaukeeUSA
  3. 3.Division of Pediatric CardiologyUniversity of IowaIowa CityUSA

Personalised recommendations