Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
复制标题
DOI：
10.1161/cir.0000000000000275
复制
发表时间：
2015-10-20
期刊：
影响因子：
37.8
通讯作者：
Pintos, Remigio Veliz
中科院分区：
文献类型：
--
作者：
de Caen, Allan R.;Maconochie, Ian K.;Pintos, Remigio Veliz
儿科工作组审查了国际复苏联络委员会（ILCOR）成员理事会在2010年提交的所有问题，审查了所有理事会培训材料和复苏指南和算法，并讨论了最近感兴趣和有争议的领域。我们根据历史上的建议，如ABC，确定了议会特定指导方针中存在关键差异的几个领域（气道、呼吸、循环）与CAB（循环、气道、呼吸）提供心肺复苏（CPR）的顺序，针对异物气道阻塞的初始背部打击与腹部推力，推荐胸部按压速率的上限，和可电击节律的初始除颤剂量（2与4 J/kg）。我们制作了一份优先问题和主题的工作清单，并随着新研究证据的出现而进行了调整。这导致了ILCOR工作组重点关注的21个皮科（人群、干预、比较、结局）问题的优先顺序。2015年的过程得到了信息专家的支持，他们进行了深入的系统检索，与儿科内容专家保持联系，以便确定最合适的术语和结果以及最相关的出版物。在与其他工作组重叠的皮科问题中，或当儿科数据不足时，考虑（外推）相关成人文献。在极少数情况下（缺乏足够的人体数据），将适当的动物研究纳入文献综述中。然而，只有在没有更高水平的证据并且该主题被认为至关重要时，才考虑这些数据。在制定皮科问题时，工作组认为评估超出自主循环恢复（ROSC）或儿科重症监护室（PICU）出院的患者结局很重要。认识到这些指标不仅对临床医生而且对父母和护理人员都有意义，因此在相关皮科问题中纳入了30天、60天、180天和1年时神经系统状态良好的长期结局。
The Pediatric Task Force reviewed all questions submitted by the International Liaison Committee on Resuscitation (ILCOR) member councils in 2010, reviewed all council training materials and resuscitation guidelines and algorithms, and conferred on recent areas of interest and controversy. We identified a few areas where there were key differences in council-specific guidelines based on historical recommendations, such as the ABC (Airway, Breathing, Circulation) versus CAB (Circulation, Airway, Breathing) sequence of provision of cardiopulmonary resuscitation (CPR), initial back blows versus abdominal thrusts for foreign-body airway obstruction, an upper limit for recommended chest compression rate, and initial defibrillation dose for shockable rhythms (2 versus 4 J/kg). We produced a working list of prioritized questions and topics, which was adjusted with the advent of new research evidence. This led to a prioritized palate of 21 PICO (population, intervention, comparator, outcome) questions for ILCOR task force focus. The 2015 process was supported by information specialists who performed in-depth systematic searches, liaising with pediatric content experts so that the most appropriate terms and outcomes and the most relevant publications were identified. Relevant adult literature was considered (extrapolated) in those PICO questions that overlapped with other task forces, or when there were insufficient pediatric data. In rare circumstances (in the absence of sufficient human data), appropriate animal studies were incorporated into reviews of the literature. However, these data were considered only when higher levels of evidence were not available and the topic was deemed critical.When formulating the PICO questions, the task force felt it important to evaluate patient outcomes that extend beyond return of spontaneous circulation (ROSC) or discharge from the pediatric intensive care unit (PICU). In recognition that the measures must have meaning, not only to clinicians but also to parents and caregivers, longer-term outcomes at 30 days, 60 days, 180 days, and 1 year with favorable neurologic status were included in the relevant PICO questions.