The new guidelines for cardiopulmonary resuscitation: a critical analysis.
OBJECTIVE
To describe the new American Heart Association (AHA) guidelines for pediatric life support, based on the scientific evidence evaluated by the International Liaison Committee on Resuscitation, and endorsed and disseminated by North American resuscitation councils.


METHODS
The guidelines for basic and advanced life support published in Circulation in November 2005 were reviewed together with subsequent publications on the same topics, identified in PubMed and MEDLINE using the keywords cardiac arrest, basic life support, advanced life support, cardiopulmonary resuscitation and pediatric resuscitation.


RESULTS
The greatest guideline changes are in the area of basic life support. The new guidelines emphasize the new chest compression/ventilation ratio for trained health professionals, which is now 15:2 for all children except neonates. Also emphasized is the need for harder and faster chest compressions, and the need to avoid hyperventilation during and after cardiorespiratory arrest. The use of high-dose epinephrine has been removed, as have some other previous recommendations.


CONCLUSIONS
The most recent AHA guidelines for pediatric resuscitation are focused primarily on basic life support care. They are based on the best available scientific evidence, although further research is required to validate these changes and provide new evidence for future guidelines.
Zorzela
Liliane
L
UTI Pediátricia, Stollery Children's Hospital, Edmonton, AB, Canadá.
Garros
Daniel
D
de Caen
Allan R
AR
D000572:American Heart Association; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D008020:Life Support Care; D017410:Practice Guidelines as Topic; D014481:United States