Abstract
ABSTRACTThe objective of the present study was to assess the efficacy of different doses, times for infusion of the first dose, intervals of administration of subsequent doses, and number of epinephrine doses in the survival of children and adolescents who went into cardiorespiratory arrest. It is a review study with data from the PubMedⓇ/MEDLINEⓇdatabase. The search was for articles published from January 1st, 2000 to February 10, 2019, with a sample of patients aged under 18 years, published in English, Portuguese and Spanish. We found 222 articles, of which 16 met the inclusion criteria of the study. The first dose should be given as soon as possible. The standard dose (0.01mg/kg) has a better outcome when compared to the higher dose (0.1mg/kg). There is an iⓇverse relation between the number of epinephrine doses and survival. The interval currently recommended between doses has lower survival when compared to larger intervals. The dosage recommended by the American Heart Association presents a better outcome for survival, but the interval between doses and the maximum number of doses should be better assessed.
Highlights
Epinephrine was isolated in 1900.(1) It began to be used for treating cardiorespiratory arrest in the 1960 ́s.(2) The American Heart Association einstein (São Paulo). 2020;18:1-7Faria JC, Victorino CA, Sato MA (AHA) currently indicates epinephrine to be administered as soon as possible at a dose of 0.01mg/kg, and at 3-to-5-minute intervals between subsequent doses.[3]
Delay in the administration of epinephrine is associated with decreased survival.[5]. There is a direct relation between time to administration of epinephrine during cardiopulmonary resuscitation for survival in children.[6,7] When compared to placebo, moderate quality evidence has shown that the standard dose of epinephrine improved return of spontaneous circulation, and survival up to hospital discharge for individuals who had an out-of-hospital cardiac arrest.[8]
The relevant aspects for the comparison of articles found in the literature using the chosen keywords are the following: Time to administration of first epinephrine dose Three studies assessed if time to administration of first epinephrine dose influenced survival
Summary
Epinephrine was isolated in 1900.(1) It began to be used for treating cardiorespiratory arrest in the 1960 ́s.(2) The American Heart Association einstein (São Paulo). 2020;18:1-7Faria JC, Victorino CA, Sato MA (AHA) currently indicates epinephrine to be administered as soon as possible at a dose of 0.01mg/kg (maximum of 1mg), and at 3-to-5-minute intervals between subsequent doses.[3]. Epinephrine was isolated in 1900.(1) It began to be used for treating cardiorespiratory arrest in the 1960 ́s.(2) The American Heart Association einstein (São Paulo). American Heart Association recommendations in pediatrics are similar to those for adults, except for dosage of epinephrine, and indication in cardiorespiratory arrest and the same administration time interval remain. It is, important to determine if the protocol that is being followed in pediatrics has consequences that may or may not be the most appropriate for patients. Studies that assessed the efficacy of epinephrine to treat cardiorespiratory arrest in the pediatric age group were included
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