UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Primary drugs in pediatric resuscitation

Author
Pamela Bailey, MD
Section Editor
Susan B Torrey, MD
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

The primary drugs used for pediatric resuscitation are reviewed here.

Pediatric basic life support, pediatric advanced life support, and the use of naloxone in children with opioid intoxication are discussed separately:

(See "Pediatric basic life support for healthcare providers".)

(See "Pediatric advanced life support (PALS)".)

(See "Opioid intoxication in children and adolescents", section on 'Naloxone'.)

                  

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Tue Feb 09 00:00:00 GMT+00:00 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Kleinman ME, Chameides L, Schexnayder SM, et al. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122:S876.
  2. Pediatric Advanced Life Support Provider Manual, Samson RA, Schexnayder SM, Hazinski MF (Eds), American Heart Association, Dallas 2012. p.209.
  3. Michaud LJ, Rivara FP, Longstreth WT Jr, Grady MS. Elevated initial blood glucose levels and poor outcome following severe brain injuries in children. J Trauma 1991; 31:1356.
  4. D'Alecy LG, Lundy EF, Barton KJ, Zelenock GB. Dextrose containing intravenous fluid impairs outcome and increases death after eight minutes of cardiac arrest and resuscitation in dogs. Surgery 1986; 100:505.
  5. Nakakimura K, Fleischer JE, Drummond JC, et al. Glucose administration before cardiac arrest worsens neurologic outcome in cats. Anesthesiology 1990; 72:1005.
  6. Voorhies TM, Rawlinson D, Vannucci RC. Glucose and perinatal hypoxic-ischemic brain damage in the rat. Neurology 1986; 36:1115.
  7. American Heart Association. Web-based Integrated Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care - Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality. ECCguidelines.heart.org (Accessed on October 15, 2015).
  8. Atkins DL, Berger S, Duff JP, et al. Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:S519.
  9. Paradis NA, Koscove EM. Epinephrine in cardiac arrest: a critical review. Ann Emerg Med 1990; 19:1288.
  10. Goetting MG, Paradis NA. High-dose epinephrine improves outcome from pediatric cardiac arrest. Ann Emerg Med 1991; 20:22.
  11. Paradis NA, Martin GB, Rivers EP, et al. Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation. JAMA 1990; 263:1106.
  12. Michael JR, Guerci AD, Koehler RC, et al. Mechanisms by which epinephrine augments cerebral and myocardial perfusion during cardiopulmonary resuscitation in dogs. Circulation 1984; 69:822.
  13. Ludwig S, Lavelle JM. Resuscitation-pediatric basic and advanced life support. In: Textbook of Pediatric Emergency Medicine, 5th ed, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p.3.
  14. Otto CW, Yakaitis RW, Blitt CD. Mechanism of action of epinephrine in resuscitation from asphyxial arrest. Crit Care Med 1981; 9:321.
  15. Kleinman ME, de Caen AR, Chameides L, et al. Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Pediatrics 2010; 126:e1261.
  16. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part VII. Neonatal resuscitation. JAMA 1992; 268:2276.
  17. Orlowski JP, Gallagher JM, Porembka DT. Endotracheal epinephrine is unreliable. Resuscitation 1990; 19:103.
  18. Zaritsky A. Pediatric resuscitation pharmacology. Members of the Medications in Pediatric Resuscitation Panel. Ann Emerg Med 1993; 22:445.
  19. Brown CG, Werman HA, Davis EA, et al. Comparative effect of graded doses of epinephrine on regional brain blood flow during CPR in a swine model. Ann Emerg Med 1986; 15:1138.
  20. Brown CG, Werman HA, Davis EA, et al. The effects of graded doses of epinephrine on regional myocardial blood flow during cardiopulmonary resuscitation in swine. Circulation 1987; 75:491.
  21. Gonzalez ER, Ornato JP, Garnett AR, et al. Dose-dependent vasopressor response to epinephrine during CPR in human beings. Ann Emerg Med 1989; 18:920.
  22. Goetting MG, Paradis NA. High dose epinephrine in refractory pediatric cardiac arrest. Crit Care Med 1989; 17:1258.
  23. Dieckmann RA, Vardis R. High-dose epinephrine in pediatric out-of-hospital cardiopulmonary arrest. Pediatrics 1995; 95:901.
  24. Brown CG, Martin DR, Pepe PE, et al. A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital. The Multicenter High-Dose Epinephrine Study Group. N Engl J Med 1992; 327:1051.
  25. Stiell IG, Hebert PC, Weitzman BN, et al. High-dose epinephrine in adult cardiac arrest. N Engl J Med 1992; 327:1045.
  26. Berg RA, Otto CW, Kern KB, et al. A randomized, blinded trial of high-dose epinephrine versus standard-dose epinephrine in a swine model of pediatric asphyxial cardiac arrest. Crit Care Med 1996; 24:1695.
  27. Carpenter TC, Stenmark KR. High-dose epinephrine is not superior to standard-dose epinephrine in pediatric in-hospital cardiopulmonary arrest. Pediatrics 1997; 99:403.
  28. Perondi MB, Reis AG, Paiva EF, et al. A comparison of high-dose and standard-dose epinephrine in children with cardiac arrest. N Engl J Med 2004; 350:1722.
  29. American Heart Association. Management of cardiac arrest. Circulation 2005; 112:IV.
  30. Haft JI. Cardiovascular injury induced by sympathetic catecholamines. Prog Cardiovasc Dis 1974; 17:73.
  31. Rivers EP, Wortsman J, Rady MY, et al. The effect of the total cumulative epinephrine dose administered during human CPR on hemodynamic, oxygen transport, and utilization variables in the postresuscitation period. Chest 1994; 106:1499.
  32. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part VI. Pediatric advanced life support. JAMA 1992; 268:2262.
  33. Stroumpoulis K, Xanthos T, Rokas G, et al. Vasopressin and epinephrine in the treatment of cardiac arrest: an experimental study. Crit Care 2008; 12:R40.
  34. Jing XL, Li X, Li H, et al. Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis. Signa Vitae 2010; 5:20.
  35. Mann K, Berg RA, Nadkarni V. Beneficial effects of vasopressin in prolonged pediatric cardiac arrest: a case series. Resuscitation 2002; 52:149.
  36. Gil-Antón J, López-Herce J, Morteruel E, et al. Pediatric cardiac arrest refractory to advanced life support: is there a role for terlipressin? Pediatr Crit Care Med 2010; 11:139.
  37. Yilidzdaş D, Horoz OO, Erdem S. Beneficial effects of terlipressin in pediatric cardiac arrest. Pediatr Emerg Care 2011; 27:865.
  38. Duncan JM, Meaney P, Simpson P, et al. Vasopressin for in-hospital pediatric cardiac arrest: results from the American Heart Association National Registry of Cardiopulmonary Resuscitation. Pediatr Crit Care Med 2009; 10:191.
  39. Chang PM, Silka MJ, Moromisato DY, Bar-Cohen Y. Amiodarone versus procainamide for the acute treatment of recurrent supraventricular tachycardia in pediatric patients. Circ Arrhythm Electrophysiol 2010; 3:134.
  40. Quail MA, Till J. Question 3 Does a higher initial dose of adenosine improve cardioversion rates in supraventricular tachycardia? Arch Dis Child 2012; 97:177.
  41. American Heart Association. Web-based Integrated Guidelines for Cardiopulmonary and Emergency Cardiovascular Care - Part 12. Pediatric advanced life support. https://eccguidelines.heart.org/index.php/circulation/cpr-ecc-guidelines-2/part-12-pediatric-advanced-life-support/ (Accessed on November 10, 2015).
  42. de Caen AR, Berg MD, Chameides L, et al. Part 12: Pediatric Advanced Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132:S526.
  43. Fishberger SB, Hannan RL, Welch EM, Rossi AF. Amiodarone for pediatric resuscitation: a word of caution. Pediatr Cardiol 2009; 30:1006.
  44. Perry JC, Fenrich AL, Hulse JE, et al. Pediatric use of intravenous amiodarone: efficacy and safety in critically ill patients from a multicenter protocol. J Am Coll Cardiol 1996; 27:1246.
  45. Valdes SO, Donoghue AJ, Hoyme DB, et al. Outcomes associated with amiodarone and lidocaine in the treatment of in-hospital pediatric cardiac arrest with pulseless ventricular tachycardia or ventricular fibrillation. Resuscitation 2014; 85:381.
  46. Saul JP, Scott WA, Brown S, et al. Intravenous amiodarone for incessant tachyarrhythmias in children: a randomized, double-blind, antiarrhythmic drug trial. Circulation 2005; 112:3470.
  47. Ramusovic S, Läer S, Meibohm B, et al. Pharmacokinetics of intravenous amiodarone in children. Arch Dis Child 2013; 98:989.
  48. Luedtke SA, Kuhn RJ, McCaffrey FM. Pharmacologic management of supraventricular tachycardias in children. Part 2: Atrial flutter, atrial fibrillation, and junctional and atrial ectopic tachycardia. Ann Pharmacother 1997; 31:1347.
  49. Dauchot P, Gravenstein JS. Effects of atropine on the electrocardiogram in different age groups. Clin Pharmacol Ther 1971; 12:274.
  50. Todd GL, Baroldi G, Pieper GM, et al. Experimental catecholamine-induced myocardial necrosis. I. Morphology, quantification and regional distribution of acute contraction band lesions. J Mol Cell Cardiol 1985; 17:317.
  51. Goetting MG, Contreras E. Systemic atropine administration during cardiac arrest does not cause fixed and dilated pupils. Ann Emerg Med 1991; 20:55.
  52. Atropine. In: Martindale: The Complete Drug Reference, Sweetman SC (Ed), Pharmaceutical Press, London. Electronic version 2011.
  53. O'Rourke GW, Greene NM. Autonomic blockade and the resting heart rate in man. Am Heart J 1970; 80:469.
  54. Barrington KJ. The myth of a minimum dose for atropine. Pediatrics 2011; 127:783.
  55. Barrington KJ, Byrne PJ. Premedication for neonatal intubation. Am J Perinatol 1998; 15:213.
  56. Ushay HM, Notterman DA. Pharmacology of pediatric resuscitation. Pediatr Clin North Am 1997; 44:207.
  57. Ettinger PO, Regan TJ, Oldewurtel HA. Hyperkalemia, cardiac conduction, and the electrocardiogram: a review. Am Heart J 1974; 88:360.
  58. Hoffman JR, Votey SR, Bayer M, Silver L. Effect of hypertonic sodium bicarbonate in the treatment of moderate-to-severe cyclic antidepressant overdose. Am J Emerg Med 1993; 11:336.
  59. Weil MH, Rackow EC, Trevino R, et al. Difference in acid-base state between venous and arterial blood during cardiopulmonary resuscitation. N Engl J Med 1986; 315:153.
  60. Steedman DJ, Robertson CE. Acid base changes in arterial and central venous blood during cardiopulmonary resuscitation. Arch Emerg Med 1992; 9:169.
  61. Máttar JA, Weil MH, Shubin H, Stein L. Cardiac arrest in the critically ill. II. Hyperosmolal states following cardiac arrest. Am J Med 1974; 56:162.
  62. Aufderheide TP, Martin DR, Olson DW, et al. Prehospital bicarbonate use in cardiac arrest: a 3-year experience. Am J Emerg Med 1992; 10:4.
  63. Howell JH. Sodium bicarbonate in the perinatal setting--revisited. Clin Perinatol 1987; 14:807.
  64. Coté CJ, Greenhow DE, Marshall BE. The hypotensive response to rapid intravenous administration of hypertonic solutions in man and in the rabbit. Anesthesiology 1979; 50:30.
  65. Srinivasan V, Morris MC, Helfaer MA, et al. Calcium use during in-hospital pediatric cardiopulmonary resuscitation: a report from the National Registry of Cardiopulmonary Resuscitation. Pediatrics 2008; 121:e1144.
  66. Broner CW, Stidham GL, Westenkirchner DF, Watson DC. A prospective, randomized, double-blind comparison of calcium chloride and calcium gluconate therapies for hypocalcemia in critically ill children. J Pediatr 1990; 117:986.