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Neonatal Intensive Care Drug Manual
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| bet | 29/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Evidence summary
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ILCOR treatment recommendation (2020):
If the heart rate has not increased to 60/min or greater after optimizing ventilation and chest compressions, administer intravascular epinephrine (adrenaline) (0.01–0.03 mg/kg) (weak recommendation, very low-certainty evidence).
If intravascular access is not yet available, administer endotracheal epinephrine (adrenaline) at a larger dose (0.05–0.1 mg/kg) than the dose used for IV administration (weak recommendation, very low-certainty evidence). The administration of endotracheal epinephrine (adrenaline) should not delay attempts to establish vascular access (weak recommendation, very low-certainty evidence).
Administer further doses of epinephrine (adrenaline) every 3 to 5 minutes, preferably intravascularly, if the heart rate remains less than 60/min (weak recommendation, very low-certainty evidence).
If the response to endotracheal epinephrine (adrenaline) is inadequate, give an intravascular as soon as vascular access is obtained, regardless of the interval after any initial endotracheal dose (weak recommendation, very low-certainty evidence). [1]
The plasma half-life of intratracheal adrenaline for newborn resuscitation is
likely to average ~50 minutes. [3]
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References
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Wyckoff MH, Wyllie J, Aziz K, de Almeida MF, Fabres JW, Fawke J, Guinsburg R, Hosono S, Isayama T, Kapadia VS, Kim HS, Liley HG, McKinlay CJD, Mildenhall L, Perlman JM, Rabi Y, Roehr CC, Schmölzer GM, Szyld E, Trevisanuto D, Velaphi S, Weiner GM; Neonatal Life Support Collaborators. Neonatal Life Support 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2020 Nov;156:A156-A187. doi: 10.1016/j.resuscitation.2020.09.015. Epub 2020 Oct 21. PMID: 33098917.
Perlman JM, Wyllie J, Kattwinkel J, Wyckoff MH, Aziz K, Guinsburg R, Kim HS, Liley HG, Mildenhall L, Simon WM, et al.; on behalf of the Neonatal Resuscitation Chapter Collaborators. Part 7: neonatal resuscitation: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.Circulation. 2015; 132(suppl 1):S204–S241. doi: 10.1161/CIR.000000000000027
Schwab KO, von Stockhausen HB. Plasma catecholamines after endotracheal administration of adrenaline during postnatal resuscitation. Archives of disease in childhood Fetal and neonatal edition. 1994;70:F213-7.
4. Truven Health Analytics. Adrenaline. In: NeoFax [Internet]. Greenwood Village (CO): Truven Health Analytics; 2020 [cited 31-12-2020]. Available from: https://neofax.micromedexsolutions.com/Australian Injectable Drugs Handbook, 8th Edition, Society of Hospital Pharmacists of Australia 2020
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Original version Date: 9/1/2014
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Author: AK, JD
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Current Version number: 2
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Current Version Date: 31/12/2020
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Risk Rating: Low
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Due for Review: 31/12/2025
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Approval by: DTC
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Approval Date: TBA
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