Postreanimationsbehandlung bei Kindern

In den deutschsprachigen Ländern erleiden jährlich etwa 5000 Kinder einen Atem-Kreislauf-Stillstand. Die Prognose der Kinder kann durch multimodale Maßnahmen während und nach erfolgreicher Reanimation positiv beeinflusst werden. Dieser Artikel greift den aktuellen Kenntnisstand der Postreanimationsbehandlung auf und strukturiert das praktische Vorgehen.

Kernaussagen

• Die Aufrechterhaltung der Homöostase mit strikter Normoxie, Normoventilation und Normotension sowie konsequenter Vermeidung einer Hyperthermie haben entscheidenden Einfluss auf die Schwere des Post Cardiac Arrest Syndrome.

• Die Gesamtprognose hängt insbesondere vom Ausmaß der hypoxisch-ischämischen Enzephalopathie ab.

• Eine Prognoseeinschätzung kann i. d. R. erst Tage nach dem Atem-Kreislauf-Stillstand erfolgen und basiert auf der klinischen Verlaufsbeobachtung in Kombination mit multimodalen Untersuchungsergebnissen.

• Eine frühzeitige Betreuung der Eltern schwer kranker Kinder kann Ängste lindern und sich positiv auf den Krankheitsverlauf des Kindes auswirken.

• Debriefing des Behandlungsteams ist ein wichtiges Instrument zur Steigerung der Behandlungsqualität.

Schlüsselwörter

Cardiac-Arrest-Syndrome - Postreanimationsbehandlung - Reanimation - Return of Spontaneous Circulation (ROSC) - Debriefing - Hirnödem

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