Cardiac Arrest, Post CPR — Prognostic Guidance — Clinical Pathway: ICU

Post-CPR Clinical Pathway — PICU, CICU and N/IICU

Prognostic Guidance

Prognosis following cardiac arrest is individualized and is aided by consultation with a neurologist. Prognosis should take the child’s pre-arrest neurologic status, co-morbid chronic and acute medical problems, post-cardiac arrest neuroimaging, EEG studies and clinical exam into account. Clinicians should take into account the effect of therapeutic hypothermia on clinical assessment and clearance of sedative drugs when conferring a prognosis.

Death by Neurological Criteria

Evaluation for Death by Neurological Criteria may be indicated in a child after cardiac arrest who has experienced profound injury. There are explicit criteria and procedures defined for this evaluation. For additional guidance, see The 2023 American Academy of Neurology, American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine Pediatric and Adult Brain Death/Death by Neurologic Criteria Determination Consensus Guidelines: What the Critical Care Team Needs to Know  .

Considerations for Children Undergoing Targeted Temperature Management 33°C, Formerly Induced Hypothermia

Hypothermia impacts the metabolism of sedating agents and data suggests that the timing of the determination of irreversible cessation of neurologic function should be modified to account for this slowed metabolism.

Policies and Procedures