Mar 18, 2017

Thermoregulate, autoregulate and ventilate: brain-directed critical care for pediatric cardiac arrest

Current Opinion in Pediatrics
Jonathan E KurzMark S Wainwright

Abstract

Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia. As a result, targeted normothermic temperature management has become standard of care. Continuous electroencephalographic monitoring during the acute postarrest period provides useful additional data for neurologic prognostication, in addition to its value for detection of seizures. Ongoing research into noninvasive monitoring of cerebrovascular autoregulation has the potential to individualize blood pressure goals in the postarrest period, maximizing cerebral perfusion in these patients. Therapeutic strategies after cardiac arrest seek to maximize cerebral perfusion while mi...Continue Reading

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Mentioned in this Paper

Care of Intensive Care Unit Patient
Brain Injuries
Research
Administration of Neuroprotective Agent
Hypoxia-Ischemia, Brain
Brain
Basic Cardiac Life Support
Pediatric Discipline
Patient Care
Procedure on Brain

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