Which antiarrhythmic drug therapy is best for pediatric shock-refractory ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest?

BEEM Bottom Line

Why is this study important?

Why is this guideline and at least some of its recommendations important? The most common cause of pediatric cardiac arrest in children is due to respiratory failure or shock, which usually results in asystole or puseless electrical activity (PEA) cardiac arrest rhythm. The optimal antiarrhythmic drug of choice for pediatric shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) is still unknown. Inferences cannot be made from the adult population research because cardiac arrest in adults, in which VF/pVT is the most common (44%) arrest rhythm, is often due to ischemia from coronary occlusion. In contrast, ventricular arrhythmias are uncommon (7–14%) in pediatric cardiac arrests. The 3-phase time-sensitive model of resuscitation and administration of antiarrhythmic drug administration; therefore, might not apply to the pediatric cardiac arrest population.[1]

Which, if any, threats to validity are most likely to have an impact on the results and how?

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