CONTROVERSIES IN PEDIATRIC CARDIOPULMONARY-RESUSCITATION

Despite the American Heart Association's attempts to promote education and training in cardiopulmonary resuscitation (CPR) techniques, the outcome of children who sustain cardiopulmonary arrest remains dismal. The most common etiologic factors are respiratory disorders, sudden infant death syndrome, and trauma. None of the ''new'' methods of closed-chest CPR has resulted in significant improvement in survival rates. Open-chest CPR improves survival only when instituted within 10 to 20 minutes of the cardiac arrest. High-dose epinephrine during CPR improves blood pressure. Rational guidelines are presented for the discontinuation of CPR in children.