Key result
Attenuated adult biphasic shocks are at least as safe and effective as standard monophasic weight-based dosing, supporting automated external defibrillator use in children 1 to 8 years of age.
Why the study?
Do attenuated adult biphasic shocks safely and effectively treat prolonged ventricular fibrillation in pediatric patients?
Do attenuated adult biphasic shocks safely and effectively treat prolonged ventricular fibrillation in pediatric patients?
Attenuated adult biphasic shocks are safe and effective for pediatric defibrillation, supporting AHA guidelines for AED use in children aged 1 to 8 years.
Answers are grounded in this paper and cite their sources.
Supports pediatric AED protocols cautiously; leaves open confirmation via prospective randomized trials.
OBJECTIVE: To evaluate published data regarding the treatment of prolonged pediatric defibrillation, with special emphasis on the use of attenuated adult biphasic shocks for pediatric defibrillation. DESIGN: Review relevant human and animal literature. RESULTS: Rhythm analysis algorithms from two manufacturers of automated external defibrillators can accurately distinguish shockable from nonshockable rhythms in children. Theoretical considerations and transthoracic impedance data from animals and children suggest that pediatric defibrillation doses should not necessarily vary in a simple weight-based manner. Two piglet studies have established that an attenuated adult biphasic dosage can be successfully used for 3.5- to 24-kg animals in ventricular fibrillation. One study established that the attenuated adult biphasic dosage was at least as safe and effective as the standard monophasic weight-based dosing. CONCLUSION: This review supports the American Heart Association's new guidelines for pediatric automated external defibrillator usage: "Automated external defibrillators may be used for children 1 to 8 yrs of age who have no signs of circulation. Ideally the device should deliver a pediatric dose. The arrhythmia detection system used in the device should demonstrate high specificity for pediatric shockable rhythms, i.e., it will not recommend delivery of a shock for nonshockable rhythms."
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Robert A. Berg (2004) conducted a review in Prolonged pediatric ventricular fibrillation. Attenuated adult biphasic shocks vs. Standard monophasic weight-based dosing was evaluated. Attenuated adult biphasic shocks are at least as safe and effective as standard monophasic weight-based dosing, supporting automated external defibrillator use in children 1 to 8 years of age.
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