Potential Complications of High-Dose Epinephrine-Reply

Abstract

In Reply. — Fleg suggests an interesting possibility. None of the animal studies that support the use of larger doses of epinephrine for the treatment of cardiac arrest has considered age. 1 We would also guess that most of the animals studied were not senescent. Our study compared the pressor response after standard- and high-dose epinephrine and found that in patients in prolonged cardiac arrest there was a significant difference in the change in coronary perfusion pressure after standard and high doses of epinephrine, with high-dose epinephrine causing a greater increase. To answer Fleg's question, we analyzed the difference in pressor response with respect to age. This showed no significant relationship ( r =.23; P =.46). Although this does not indicate a relationship between age and response to high-dose epinephrine, the small sample size could easily hide a slight effect. Because the serum levels of epinephrine after administration of high-dose epinephrine