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

Abstract:

BACKGROUND:If intravenous access cannot be accomplished during cardiopulmonary resuscitation in children, tracheal administration of 100 micrograms/kg of adrenaline (ten times greater than the intravenous dose) is recommended. METHODS:In a randomized crossover study we recoreded the hemodynamic effect of a low dose of intravenous adrenaline and a ten times greater tracheal dose. While anesthetized for open heart surgery, fourteen infants received one dose of adrenaline intravenously (0.3 microgram/kg) and the other tracheally (3 micrograms/kg). RESULTS:During the first 5 minutes after administration mean arterial pressure (MAP) and heart rate (HR) increased after both intravenous and tracheal administration (P < 0.001). The maximum increase in MAP was 28% (17-68%, median and range) after intravenous injection and 20% (6-69%, P < 0.05 when compared to intravenous injection) after tracheal instillation. In four infants, MAP increased less than 10% after tracheal instillation. The maximum increases in MAP and HR occurred 1 min (1-2 min) after intravenous injection and 3 min (2-4 min) after tracheal instillation (P < 0.001). CONCLUSION: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.

authors

Jonmarker C,Olsson AK,Jögi P,Forsell C

doi

10.1111/j.1399-6576.1996.tb04562.x

subject

Has Abstract

pub_date

1996-09-01 00:00:00

pages

927-31

issue

8 Pt 1

eissn

0001-5172

issn

1399-6576

journal_volume

40

pub_type

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