Hemodynamic effects of tracheal and intravenous adrenaline in infants with congenital heart anomalies

Jonmarker, Christer; Olsson, Anneli; Jögi, Peeter; Forsell, C.

doi:10.1111/j.1399-6576.1996.tb04562.x

Cited by 13 publications

(2 citation statements)

References 11 publications

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“…Although early experimental work by Redding et al 17 suggested that a ETT epinephrine dose (0.1 mg/kg) would be as effective as intravenous epinephrine in achieving return of spontaneous circulation from asphyxia-induced cardiac arrest, most subsequent studies demonstrated that ETT epinephrine is poorly or slowly absorbed and takes longer to work. [9][10][11][12] Many investigators report that even in adult animal models 10,12,[18][19][20] and human patients with intact circulation [21][22][23] (and thus likely sufficient pulmonary perfusion), Ն10 times the currently recommended dose of ETT epinephrine is required to achieve equivalent increases in plasma epinephrine concentrations or to elicit any physiologic effect, such as a rise in blood pressure, when compared with intravenous epinephrine. Manisterski et al 24 compared different doses of ETT epinephrine, ranging from 0.02 to 0.3 mg/kg, in healthy anesthetized dogs, but only 10 to 30 times the currently recommended dose (0.3 mg/kg) led to a sustained increase in blood pressure.…”

Section: Discussionmentioning

confidence: 97%

Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room

2006

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Endotracheal epinephrine is frequently used when intensive resuscitation is required in the delivery room. The previously recommended endotracheal epinephrine dose of 0.01 to 0.03 mg/kg is often ineffective. Higher endotracheal doses will likely be needed to improve efficacy. A prospective study is needed to determine the best endotracheal epinephrine dosing regimen. Until such information is available, intravenous administration should be the preferred route of delivery.

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Section: Discussionmentioning

confidence: 97%

Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room

2006

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“…There are concerns that the endotracheal route may not result in as eective a level of epinephrine as does the intravenous route [41,47,49,53]; however, the data are insucient to recommend a higher dose via the endotracheal route. There are concerns that the endotracheal route may not result in as eective a level of epinephrine as does the intravenous route [41,47,49,53]; however, the data are insucient to recommend a higher dose via the endotracheal route.…”

Section: Routes Of Medication Administrationmentioning

confidence: 99%

ILCOR Advisory Statement

Kattwinkel¹,

Niermeyer

Tibballs

et al. 1999

European Journal of Pediatrics

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For more than a decade, mild induced hypothermia (32°C-34°C) has been standard of care for patients remaining comatose after resuscitation from out-of-hospital cardiac arrest with an initial shockable rhythm, and this has been extrapolated to survivors of cardiac arrest with initially nonshockable rhythms and to patients with in-hospital cardiac arrest. Two randomized trials published in 2002 reported a survival and neurological benefit with mild induced hypothermia. One recent randomized trial reported similar outcomes in patients treated with targeted temperature management at either 33°C or 36°C. In response to these new data, the International Liaison Committee on Resuscitation Advanced Life Support Task Force performed a systematic review to evaluate 3 key questions: (1) Should mild induced hypothermia (or some form of targeted temperature management) be used in comatose post-cardiac arrest patients? (2) If used, what is the ideal timing of the intervention? (3) If used, what is the ideal duration of the intervention? The task force used Grading of Recommendations Assessment, Development and Evaluation methodology to assess and summarize the evidence and to provide a consensus on science statement and treatment recommendations. The task force recommends targeted temperature management for adults with out-of-hospital cardiac arrest with an initial shockable rhythm at a constant temperature between 32°C and 36°C for at least 24 hours. Similar suggestions are made for out-of-hospital cardiac arrest with a nonshockable rhythm and in-hospital cardiac arrest. The task force recommends against prehospital cooling with rapid infusion of large volumes of cold intravenous fluid. Additional and specific recommendations are provided in the document.

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Reanimation von Säuglingen und Kindern

2009

Kinderanästhesie

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Hemodynamic effects of tracheal and intravenous adrenaline in infants with congenital heart anomalies

Abstract: Tracheal administration 3 micrograms/kg adrenaline increased mean arterial blood pressure in infants with congenital cardiac anomalies, but the increase occurred later and was less consistent than after 0.3 microgram/kg of adrenaline given intravenously.

Cited by 13 publications

References 11 publications

Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room

Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room

ILCOR Advisory Statement

Reanimation von Säuglingen und Kindern

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