Defibrillation in Children: Why a Range in Energy Dosing?
Dianne L. Atkins.
Infants and children have historically received a weight-based escalating defibrillation dose, commencing at
2J/kg. Researchers are increasingly suggesting that 2J/kg maybe an ineffective initial defibrillation dose. However without
a definitive study there has been hesitancy to modify this initial dose. The International Liaison Committee on Resuscitation
made a recommendation in 2010 of an initial dose of 2–4 J/Kg, increased from 2 J/Kg. The American Heart Association
and the European Resuscitation Councils now have different initial dosing recommendations for children. The ERC
advocates 4J/kg as the initial dose without escalation for subsequent shocks, while the AHA recommends 2–4 J/Kg, increasing
to ≥ 4 J/Kg with subsequent shocks up to adult dose. The difficulty of finding a dose based on robust evidence
continues to provide a stimulus for research to better define the best defibrillation energy dose for children.
Keywords: Arrest, defibrillation, child, countershock, resuscitation.
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