Health Watch -- Cardiac Arrest in Kids

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Standard guidelines offer the best way to treat children in cardiac arrest.

Cardiac arrest is rare in children and usually happens because breathing has been cut off rather than because of heart problems. Doctors need to be especially careful when reviving children in cardiac arrest because the medication used to revive them can also cause problems.

Doctors at UT Southwestern Medical Center at Dallas say that the guidelines established for giving epinephrine to children in cardiac arrest offer the best chance for a good outcome. Dr. George Lister, UT Southwestern's chairman of pediatrics, says that higher doses don't help and may even make things worse after the cardiac arrest.

Studies have shown that children who receive higher doses of epinephrine during cardiac arrest are as likely to recover from the arrest as those who receive recommended doses, but children who receive higher doses are more likely to die soon after being resuscitated. Even a dosage difference that seems trivial can significantly affect survival chances.

Epinephrine works by increasing blood flow, but that also makes organs use more oxygen. That can cause injury to vital tissues.

Dr. Lister says that sticking with established standard doses can also help prevent problems because it improves the chances of success even when emergency personnel have varying degrees of training. It also means only a few standard drug formulations have to be stocked in emergency carts and boxes.

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May 2004

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