Version October 2024
| Oxygenation and ventilation | |
| Measure oxygenation and target normoxemia 94 to 99% (or child's normal/appropriate oxygen saturation). | |
| Avoid hypoxemia. | |
| Measure PaCO2 and target a clinically appropriate value. | |
| Avoid hypocapnia. | |
| Hemodynamic monitoring | |
| Set specific hemodynamic goals during PCAC and review daily. | |
| Use cardiac telemetry. | |
| Monitor arterial blood pressure. | |
| Monitor serum lactate, urine output, and central venous oxygen saturation to help guide therapies. | |
| Use parenteral fluid bolus with or without inotropes or vasopressors to maintain a systolic blood pressure greater than the fifth percentile for age and sex. | |
| TTM | |
| Measure and monitor continuous core temperature. | |
| Prevent and promptly treat fever. | |
| Apply TTM (32°C to 34°C) for 48 hours and then maintain TTM (36°C to 37.5°C) for 3 days after rewarming, or apply TTM (36°C to 37.5°C) for 5 days if patient is unresponsive after ROSC. | |
| Prevent shivering. | |
| Monitor blood pressure and treat hypotension during rewarming. | |
| Prevent fever after rewarming. | |
| Neuromonitoring | |
| Treat clinical seizures. | |
| Ensure no routine use of pharmacological prophylaxis for seizures. | |
| Consider early brain imaging to diagnose treatable causes of cardiac arrest. | |
| Glucose control | |
| Measure blood glucose. | |
| Avoid hypoglycemia. | |
| Sedation | |
| Treat with sedatives and anxiolytics. | |
| Prognosis | |
| Always consider multiple modalities (clinical and other) over any single predictive factor. | |
| EEG in conjunction with other factors may be useful within the first 7 days of PCAS. | |
| Neuroimaging such as MRI during the first 7 days may be valuable. | |
| Remember that assessments may be modified by TTM or induced hypothermia. | |
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