Modern principles of cardiopulmonary resuscitation in pediatric practice

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Quality improvement of cardiopulmonary resuscitation (CPR) is one of the most urgent problems in pediatric anesthesiology, resuscitation and intensive care. Despite the fact that in recent years the number of surviving children after cardiopulmonary resuscitation is constantly increasing, the number of young children among them, still small, which requires further improvement of provision of intensive care, especially in the pre-hospital stage. In the last two decades the protocols of cardiopulmonary resuscitation are regularly changed and supplemented every five years, which helps to improve outcomes of resuscitative measures. In October/November 2015 came the next recommendations of American Heart Association and European Resuscitation Council for basic and advanced cardiopulmonary resuscitation in children, which is reflected in this article. Using these recommendations will significantly improve the quality of the provision of intensive care to children and contribute to a more favorable neurological outcome even after a sudden circulatory arrest. This publication reflects the epidemiological evidence on the effectiveness and outcomes of cardiopulmonary resuscitation in pediatric practice, the modern principles of basic and advanced cardiopulmonary resuscitation in children are considered in detail, special attention is given to the use of drugs and defibrillation during resuscitation. Excerpts from the regulating documents governing the termination of resuscitation and ascertaining biological death are presented in this article.

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About the authors

Yuriy S Alexandrovich

Saint Petersburg State Pediatric Medical University of Health Ministry of Russia

MD, PhD, Dr Med Sci, Head, Dept. of Aneasthesiolgic and reanimatologic. St. Petersburg State Pediatric Medical University

Konstantin V Pshenisnov

Saint Petersburg State Pediatric Medical University of Health Ministry of Russia

h.D., Assistant Professor. The Department of Anesthesiology and Intensive Care and Emergency Pediatrics Postgraduate Education. St. Petersburg State Pediatric Medical University.


  1. Айзенберг В.А., Александрович Ю. С., Амчеславский В. Г., и др. Клинические рекомендации по сердечно-легочной реанимации у детей. Клинические рекомендации Министерства здравоохранения РФ. - М., 2014. [Ajzenberg VA, Aleksandrovich JS, Amcheslavskij VG, et al. Clinical recommendations on cardiopulmonary resuscitation of children. Clinical recommendations of Ministry of Health of the Russian Federation. Moscow; 2014. (In Russ).]
  2. Александрович Ю. С., Гордеев В. И. Базисная и расширенная реанимация у детей. - СПб.: Сотис, 2007. [Aleksandrovich JS, Gordeev VI. Basic and advanced life support of children. Saint Petersburg: Sotis; 2007. (In Russ).]
  3. Александрович Ю. С., Пшениснов К. В., Гордеев В. И. Интенсивная терапия критических состояний у детей. - СПб.: Н-Л, 2014. [Aleksandrovich JS, Pshenisnov KV, Gordeev VI. Intensive therapy of critical states in children]. Saint Petersburg: N-L; 2014. (In Russ).]
  4. Алексеева Л. А., Скрипченко Н. В., Бессонова Т. В. Лабораторные критерии эндогенной интоксикации при менингококковой инфекции у детей // Педиатр. - 2011. - Т. 2. - № 2. - С. 3-8. [Alekseeva LA, Skripchenko NV, Bessonova TV. Laboratory criterien for endogenous intoxication in meningococcal infection in children. Pediatr. 2011;2(2):3-8.]
  5. Востриков В. А., Горбунов Б. Б. Отечественная история дефибрилляции сердца // Общая реаниматология. - 2012. - Т. 8. - № 3. - С. 63-68. [Vostrikov VA, Gorbunov BB. Russian History of Cardiac Defibrillation. Obshhaja reanimatologija. 2012;8(3):63-8. (In Russ).] doi: 10.15360/1813-9779-2012-3-63.
  6. Зильбер А. П. Этюды критической медицины. - M.: МЕДпресс-информ, 2006. [Zil’ber AP. Essays on critical care medicine. Moscow: MEDpress-inform; 2006. (In Russ).]
  7. Караваев В. М. Особенности структуры повреждений при основных видах смертельной сочетанной травмы у детей // Педиатр. - 2014. - № 3. - C. 58-63. [Karavaev V M. Structural circumstances in the main types of fatal concomitant injury in children. Pediatr. 2014;(3):58-63. (In Russ).]
  8. Неговский В. А., Богушевич М. С. Н. Л. Гурвич - основоположник теории фибрилляции и дефибрилляции сердца // Фундаментальные проблемы реаниматологии. - М., 2001. - Т. 2. - С. 3-16. [Negovskij VA, Bogushevich MS. N. L. Gurvich - The founder of the theory fibrillation and defibrillation of the heart. In: Fundamental’nye problemy reanimatologii. Moscow; 2001;2:3-16. (In Russ).]
  9. Струков Д. В., Александрович Ю. С., Васильев А. Г. Актуальные проблемы сепсиса и септического шока // Педиатр. - 2014. - Т. 5. - № 2. - С. 81-87. [Strukov DV, Aleksandrovich JS, Vasil’ev AG. Actual aspects sepsis and septic shock. Pediatr. 2014;5(2):81-87. (In Russ).]
  10. Abella BS, Sandbo N, Vassilatos P, et al. Chest compression rates during cardiopulmonary resuscitation are suboptimal: a prospective study during in-hospital cardiac arrest. Circulation. 2005;111(4):428-34. doi: 10.1161/01.cir.0000153811.84257.59.
  11. Atkins DL, Everson-Stewart S, Sears GK, et al. Resuscitation Outcomes Consortium Investigators. Epidemiology and outcomes from out-of-hospital cardiac arrest in children: the resuscitation outcomes consortium epistry-cardiac arrest. Circulation. 2009;119:1484-91. doi: 10.1161/circulationaha.108.802678.
  12. Berg MD, Schexnayder SM, Chameides L, et al. 2010 American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 13: Pediatric Basic Life Support. Circulation. 2010; 122;862-75. doi: 10.1161/circulationaha.110.971085.
  13. Chair DLA, Berger S, Duff JP, et al. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality. Circulation. 2015;132:519-25.
  14. De Maio V J. The quest to improve cardiac arrest survival: Overcoming the hemodynamic effects of ventilation. Crit Care Med. 2005;33(4):898-9. doi: 10.1097/01.ccm.0000159748.51702.20.
  15. Girotra S, Spertus JA, Li Y, et al. American Heart Association Get With The Guidelines - Resuscitation Investigators. Survival trends in pediatric in-hospital cardiac arrests: an analysis from get with the guidelines-resuscitation. Circ Cardiovasc Qual Outcomes. 2013;6:42-9. doi: 10.1161/circoutcomes.112.967968.
  16. Herlitz J, Engdahl J, Svensson L, et al. Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden. Resuscitation. 2005;64:37-40. doi: 10.1016/j.resuscitation.2004.06.019.
  17. Jayaram N, McNally B, Tang F, Chan PS. Survival after out-of-hospital cardiac arrest in children. J Am Heart Assoc. 2015;4(10):002122. doi: 10.1161/jaha.115.002122.
  18. Klauwer D, Neuhäuser C, Thul J, Zimmermann R. Pädiatrische Intensivmedizin - Kinderkardiologische Praxis. Deutscher Aerzte-Verlag, 2013.
  19. Kouwenhoven W B, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA. 1960;173:1064-7.
  20. Lenzer J. Peter Josef Safar. BMJ. 2003;327 (7415):624. doi: 10.1136/bmj.327.7415.624.
  21. Maconochiea IK, Binghamb R, Eichc C, López-Herced J et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 6. Paediatric life support. Resuscitation. 2015;95:223-48.
  22. Meaney PA, Nadkarni VM, Cook EF, et al. Higher survival rates among younger patients after pediatric intensive care unit cardiac arrests. Pediatrics. 2006;118:2424-33. doi: 10.1542/peds.2006-1724.
  23. Nadkarni VM, Larkin GL, Peberdy MA, et al. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006;295:50-7. doi: 10.1001/jama.295.1.50.
  24. Oh JH, Kim CW, Kim SE, Lee SJ, Lee DH. Comparison of chest compressions in the standing position beside a bed at knee level and the kneeling position: a non-randomised, single-blind, cross-over trial. J Emerg Med. 2014;31(7):533.
  25. Rosenberg M, Wang C, Hoffman-Wilde S, Hickam D, Hickham D corrected to Hickam D. Results of cardiopulmonary resuscitation. Failure to predict survival in two community hospitals. Arch Intern Med. 1993;153(11):1370-5. doi: 10.1001/archinte.153.11.1370.
  26. Souchtchenko SS, Benner JP, Allen JL, Brady WJ. A review of chest compression interruptions during out-of-hospital cardiac arrest and strategies for the future. J Emerg Med. 2013;45(3):458-66. doi: 10.1016/j.jemermed.2013.01.023.
  27. Tibballs J, Kinney S. A prospective study of outcome of in-patient paediatric cardiopulmonary arrest. Resuscitation. 2006;71:310-8. doi: 10.1016/j.resuscitation.2006.05.009.
  28. Zoch TW, Desbiens NA, De Stefano F, et al. Short- and long-term survival after cardiopulmonary resuscitation. Arch Intern Med. 2000;160(13):1969-73. doi: 10.1001/archinte.160.13.1969.



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Copyright (c) 2016 Alexandrovich Y.S., Pshenisnov K.V.

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