Rehabilitation for the Pediatric Patient after Cardiac Arrest

What do I need to know about rehabilitation options?

We describe the different types of rehabilitation for children cardiac arrest survivors and the terminology associated with these. Rehabilitation recommendations will be based on the condition of your child and could range in length from days, weeks, months, or even years.

What is rehabilitation?

The term “rehabilitation” generally refers to the processes and services used to help individuals recover, regain strength, and adapt to life after a cardiac arrest, both physically and mentally. The type and length of rehabilitation after cardiac arrest will vary greatly for children. As with other childhood diseases and conditions, the amount of research and published information about rehabilitation after cardiac arrest in children is very limited.

The recommended rehabilitation treatment plan and length of stay at the hospital will depend on the needs and anticipated recovery of your child. Depending on the needs and recovery of the child, the healthcare team will come up with an individualized rehabilitation treatment plan. This plan may start around 72 hours (3 days) after the child’s cardiac arrest and continue throughout hospitalization. The child’s needs for rehabilitation may extend the hospital length of stay or extend beyond discharge from the hospital (outpatient care). The hospital healthcare team will provide care and treatment for both short-term and anticipated long-term conditions.

Types of rehabilitation

There are a variety of rehabilitation options. These forms of therapy can start in the hospital and continue at home as an outpatient or in a physical rehabilitation facility. Rehabilitation is an important component of the overall successful recovery of you and your child. Understanding the role of each type of therapy will help you know what to expect going forward.

Inpatient and Outpatient Services

• • Physical therapy: Focuses on improving a child’s ability to move their body.  Inpatient (in the hospital) physical therapy, unlike outpatient, requires patients to be admitted to a facility such as a hospital or rehabilitation center. 
  • Occupational therapy: Focuses on improving a child’s ability to perform activities of daily living, such as brushing their teeth or eating.
  • Speech therapy: Focuses on a child’s speech-language, voice, and swallowing abilities. 

Primarily Outpatient Services

• • Cognitive therapy: Focuses on a child’s cognitive function–such as attention, memory, reasoning, problem-solving, and executive function. 
  • Cardiac rehab: A customized outpatient program of exercise and education. The cardiac rehab program is designed to help a child improve their health and recover from their cardiac arrest. It includes physical exercise, emotional support, and education about lifestyle changes, such as eating a heart-healthy diet, sleeping well, and maintaining a healthy weight. It is a safe place for your child to exercise in a monitored setting. The goals of cardiac rehabilitation include establishing a plan to help regain strength, preventing a condition from worsening, reducing the risk of future heart problems, and improving health and quality of life. It may help you, as a co-survivor, to feel more confident about a child’s condition and abilities at home. Knowing your child was monitored successfully during cardiac rehab can help reduce fear and anxiety.

Sources

Topjian, A. A., de Caen, A., Wainwright, M. S., Abella, B. S., Abend, N. S., Atkins, D. L., Bembea, M. M., Fink, E. L., Guerguerian. A.-M., Haskell, S. E., Kilgannon, J. H., Lasa, J. J., & Hazinski, M. F. (2019). Pediatric post-cardiac arrest care: A scientific statement from the American Heart Association. Circulation, 140(6), e194–e233. https://doi.org/10.1161/CIR.0000000000000697

Thank you to our contributors

Richard Lamphier