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The American Heart Association’s cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest; however, IV calcium is routinely used. Learn more in this discussion of “Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival—A Report From the American Heart Association’s Get With the Guidelines-Resuscitation (GWTG-R) Registry."
Pediatric advanced life support (PALS) guidelines include weight-based epinephrine dosing recommendations of 0.01 mg/kg with a maximum of 1 mg, which corresponds to a weight of 100 kg. But what are the actual practice patterns? This podcast discusses the Pediatric Critical Care Medicine article “Weight-Based Versus Flat Dosing of Epinephrine During Cardiac Arrest in the PICU: A Multicenter Survey.”
Common causes of death in hospitals, such as sepsis and respiratory failure, are treatable and benefit from early intervention. Machine learning algorithms or early warning scores can be used for early identification and recognition to potentially help accelerate interventions and limit morbidity and mortality. This Concise Critical Appraisal explores an article published in Critical Care Medicine that looked at the impact of one of these early warning scores—electronic cardiac arrest risk triage (eCART)—on mortality for elevated-risk adult inpatients.
Although several trials have examined in-hospital cardiac arrest (IHCA), only two trials in the past decade have examined the use of vasopressin and glucocorticoids for IHCA. Both trials found improved survival and favorable neurologic outcome with a vasopressin-epinephrine-methylprednisolone combination. Because of a lack of additional supporting evidence, neither the American nor European international guidelines have recommended this combination for IHCA. This Concise Critical Appraisal examines an article by Andersen et al that attempted to validate the results of these trials.