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Abstract：
Child abuse was suspected in a case of out-of-hospital arrest with minor brain injuries. Confronted with continued disputes on pathophysiologic correlates even after autopsy, to assist the differentiation of potential causes of sudden cardiopulmonary arrest in children, we tried to identify the mechanism of cardiopulmonary arrest in brain injuries from different causes. Systematic review was carried out in two stages. First, major external causes of cardiopulmonary arrest among children and infants were identified from Pubmed and Google Scholar search, and then the exact sequence of cardiopulmonary arrest, and their pathophysiologic features were identified based on articles of animal models of brain injury. From the review, we have identified four major groups of external circumstances for rather sudden cardiopulmonary arrest from brain damage in children, after excluding congenital and other unrelated diseases; 1) impact brain apnea, 2) anoxic insults, 3) drug or other substance induced central nervous system depression, and 4) traumatic brain damage. Each group has different features in the course of cardiac and respiratory arrests. Based on this review of pathophysiologic features of cardio-respiratory responses from external causes, we have presented a suspected, but unlikely, child abuse case of respiratory arrest from brain injury. The social consequences of both unknowingly missing, and falsely incriminating the abuse can be grave, and the identification of the mechanisms of cardiopulmonary arrest from brain injury can be important for the differentiation of various potential causes.
摘要：
在一起因脑部轻伤而在院外被捕的案件中，怀疑虐待儿童。即使在尸检后，也面临着病理生理相关性的持续争议，协助鉴别儿童突然心肺骤停的潜在原因，我们试图从不同原因的脑损伤中找出心肺骤停的机制。系统审查分两个阶段进行。首先,从Pubmed和GoogleScholar搜索中确定了儿童和婴儿心肺骤停的主要外部原因，然后是心肺骤停的确切顺序，并根据脑损伤动物模型的文章鉴定了其病理生理特征。从审查来看,我们已经确定了四个主要的外部环境组由儿童脑损伤引起的突然心肺骤停，排除先天性和其他无关疾病后；1)影响脑呼吸暂停，2)缺氧损伤，3）药物或其他物质引起的中枢神经系统抑郁，4)创伤性脑损伤。每组在心脏和呼吸骤停过程中具有不同的特征。基于对来自外部原因的心肺反应的病理生理学特征的综述，我们提出了一个嫌疑人，但不太可能,虐待儿童因脑损伤导致呼吸停止的案例。两者在不知不觉中失踪的社会后果，错误地指控虐待行为可能是严重的，明确脑损伤导致心肺骤停的机制对于区分各种潜在原因可能很重要。
