Bradycardia with haemodynamic compromise in children: A scoping review
Why this work is in the frame
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Bibliographic record
Abstract
Background: Bradycardia with haemodynamic compromise is the most common in-hospital cardiac arrest initial rhythm in children. There are knowledge gaps in the efficacy of several treatments. This scoping review, part of the International Liaison Committee on Resuscitation continuous evidence evaluation process, sought to identify the literature on treatments for children with bradycardia and haemodynamic compromise.We searched Medline, EMBASE, and Cochrane (inception-August 19, 2025) for studies involving children with bradycardia (<60 beats per minute or low for age) and haemodynamic compromise (age-based hypotension, altered mental status, or signs of shock or cardiac arrest). Data extracted included study design, population, interventions, comparators, and outcomes.We screened 5392 titles and included 27 observational studies. In twenty-six studies, children with bradycardia with haemodynamic compromise who received CPR as part of a comprehensive protocol of drugs, airway support, and chest compressions had higher survival rates when compared with children receiving the same care for a pulseless rhythm. Three studies reported conflicting associations between clinical outcomes (progression to pulselessness, return of circulation, survival) with epinephrine use during CPR. Two studies reported atropine use in patients with haemodynamic compromise, one with CPR and one without. No studies assessed oxygen administration, assisted ventilation, or transcutaneous pacing. Conclusions: There is insufficient evidence to move to a systematic review for any treatment strategy for paediatric bradycardia with haemodynamic compromise. Current guidelines are based on limited evidence and expert opinion. Comparative trials evaluating possible treatments for children with bradycardia with haemodynamic compromise are needed.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it