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Prearrest Care of Pediatric Dilated Cardiomyopathy or Myocarditis

Question Type:
Intervention
Full Question:
For infants and children with myocarditis or dilated cardiomyopathy
and impending cardiac arrest (P), does does a specific approach (I), compared with compared with the usual management of shock or cardiac arrest (C), change Survival with Favorable neurological/functional outcome at discharge, 30 days, 60 days, 180 days AND/OR 1 year, survival to hospital discharge, Cardiac arrest frequency, ROSC (O)?
Consensus on Science:
For the critical outcome of survival to hospital discharge, we identified no evidence that a specific prearrest management strategy in patients with dilated cardiomyopathy or myocarditis shows a benefit. For the critical outcome of survival to hospital discharge, we identified no evidence that a specific anesthetic technique in patients with dilated cardiomyopathy shows any benefit. For the critical outcome of survival to hospital discharge, we identified very-low-quality evidence from a pediatric observational study (downgraded for risk of bias and imprecision)(Teele 2011, 638-643) of 20 children with acute fulminant myocarditis, which demonstrated that the pre–cardiac arrest use of extracorporeal membrane oxygenation (ECMO) may be beneficial.
Treatment Recommendation:
The confidence in effect estimates is so low that the panel decided a specific recommendation was too speculative.
CoSTR Attachments:
GDT Recommendations 12 29.14.pdf    
GDT Table 12 29.14use.pdf    

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