Why the study?
This update aligns with the continuous evidence review process to provide updated recommendations for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation or pulseless ventricular tachycardia cardiac arrest.
Does antiarrhythmic drug therapy (lidocaine or amiodarone) improve return of spontaneous circulation or survival to hospital discharge in pediatric patients with shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest?
Does antiarrhythmic drug therapy (lidocaine or amiodarone) improve return of spontaneous circulation or survival to hospital discharge in pediatric patients with shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest?
This AHA focused update reaffirms that either lidocaine or amiodarone may be used for pediatric shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
Either lidocaine or amiodarone remains acceptable for pediatric shock-refractory arrest; confirms guideline stance and leaves survival optimization open.
This 2018 American Heart Association focused update on pediatric advanced life support guidelines for cardiopulmonary resuscitation and emergency cardiovascular care follows the 2018 evidence review performed by the Pediatric Task Force of the International Liaison Committee on Resuscitation. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the group completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendation for antiarrhythmic drug therapy in pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. As was the case in the pediatric advanced life support section of the "2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care," only 1 pediatric study was identified. This study reported a statistically significant improvement in return of spontaneous circulation when lidocaine administration was compared with amiodarone for pediatric ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. However, no difference in survival to hospital discharge was observed among patients who received amiodarone, lidocaine, or no antiarrhythmic medication. The writing group reaffirmed the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
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Duff et al. (2018) conducted a review in Pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest. Lidocaine or amiodarone vs. No antiarrhythmic medication was evaluated on Return of spontaneous circulation and survival to hospital discharge. Lidocaine administration compared with amiodarone for pediatric shock-refractory cardiac arrest improved return of spontaneous circulation, but neither improved survival to hospital discharge.
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