Advances and controversies in cardiopulmonary resuscitation in the young.

Pediatric resuscitation is most frequently required for respiratory arrest. Cardiac arrest is a rare and ominous event and usually develops as a complication of shock or respiratory failure. Once asystolic cardiac arrest occurs, the outcome of any resuscitation is dismal; if cardiopulmonary arrest persists longer than 15 minutes in the normothermic child, further efforts are unlikely to result in patient recovery. For this reason, attention must focus on prevention of arrest and prompt restoration of oxygenation and ventilation, heart rate, and systemic perfusion.