Post-CPR Clinical Pathway — PICU, CICU and N/IICU
Post-CPR Clinical Pathway — PICU, CICU and N/IICU
Treatment: Clinical Goals and Vital Sign Targets
Clinical Goals
Maintain
- Normotension for age
- Normoxia (SpO2 94-99%)
- Normocapnia (CO2 35-45), use pH if chronic hypercapnia/metabolic alkalosis
- Normoglycemia (80-200 mg/dl)
- Monitor for and treat status epilepticus
Minimum Blood Pressure Goals: Mean Arterial Pressure (MAP)
and Systolic Blood Pressure (SBP)
| Age | MAP | SBP |
|---|---|---|
| Neonate | > corrected gestational age in wks | > 60 |
| 0-6 mos | > 45 | > 70 |
| > 6 mos - 2 yrs | > 55 | > 80 |
| > 2 yrs - 10 yrs | > 65 | > 90 |
| > 10 yrs | > 75 | > 100 |
- Lower BP goals may be indicated for children with operative bleeding or severely depressed ventricular function.
- Higher BP goals may be indicated for children with high central venous pressure
- e.g., right ventricular failure, superior or total cavopulmonary anastomosis
- Diastolic blood pressure is also an important consideration to ensure adequate coronary perfusion pressure and myocardial recovery following cardiac arrest.
Considerations for Children with Congenital Heart Defects
| Condition | Oxygen Saturation Goals |
|---|---|
| 2 Ventricle Patients with R to L Shunt | SpO2 80-99% (e.g., PFO after TET repair) |
| Complete Venous Admixture | SpO2 75%-85% or +/- 5% from baseline (e.g., single ventricle, shunt dependent, banded pulmonary blood flow) |