PEDIATRIC POST-CARDIAC ARREST CARE • For children and infants who remain unconscious after ROSC from cardiac arrest, it is reasonable to actively prevent fever and maintain a core temperature of 37 5° C (99 5° F) or less
PALS Post-Resuscitation Care Algorithm - CPR Lifeline Fever worsens neurological outcomes after cardiac arrest and must be prevented Target normothermia with a core body temperature between 36 and 37 5 degrees Celsius in all post-arrest patients
Part 8: Pediatric Advanced Life Support: 2025 American Heart . . . Preventing hyperthermia is a critical component of post–cardiac arrest care Avoiding central temperatures >37 5 °C can improve neurological outcomes in infants and children who remain comatose following cardiac arrest 7
Initial post-cardiac arrest care in children - UpToDate Active temperature control (also called targeted temperature management) – Active temperature control targets normal core body temperature (36 o C to 37 5 o C) or hypothermia (32 o C to 34 o C) using cooling devices or ECMO
Pediatric ROSC Post-Resuscitation Care Algorithm - CPR VAM Maintain Normal Temperature (Avoid Hypothermia and Fever): Keep the child’s temperature stable, as even mild fever after ROSC can worsen brain injury Avoid Hyperoxia: Titrate oxygen to maintain SpO₂ between 92–97% and avoid prolonged 100% oxygen to reduce the risk of oxidative brain damage
Post-CPR Clinical Pathway – PICU, CICU and N IICU Clinical Goals and Vital Sign Targets Normotension for age Normoxia Normocapnia Normoglycemia Considerations for Children with Heart Defects Treat seizures Sedate to maintain SBS -1 to -2 Consider paralytic to prevent shivering Targeted temperature management
PALS Post-Cardiac Arrest Algorithm: Managing Shock After ROSC This article details the specific steps to manage post-ROSC shock Providers will learn exactly when and how to implement this critical branch of the pediatric post-cardiac arrest algorithm to prevent secondary injury and stabilize the child
PALS Post-Resuscitation Care Algorithm - Safety Training Seminars Temperature control plays a significant role in neurological protection after cardiac arrest The algorithm recommends avoiding hyperthermia (fever) in all post-arrest patients, as elevated temperatures can worsen brain injury
What is the management for patients with return of spontaneous . . . Comatose patients with return of spontaneous circulation after cardiac arrest should receive targeted temperature management (TTM) with a constant temperature maintained between 32°C and 36°C for at least 24 hours, with active fever prevention continuing for 72 hours 1, 2
Targeted Temperature Management (TTM) Post ROSC Targeted Temperature Management (TTM) is a critical therapeutic intervention following the Return of Spontaneous Circulation (ROSC) in patients who have experienced cardiac arrest