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• W2000209851 abstract "Purpose: To determine if HDE used during pediatric out-of-hospital CPA improves survival and neurologic outcomes. Methods: Seven pediatric emergency departments randomly assigned children in CPA to receive HDE (0.1 mg/kg for the initial dose and 0.2 mg/kg for subsequent doses) or standard dose epinephrine (SDE; 0.01 mg/kg). Resuscitations were conducted following ACLS guidelines. CPA was classified as “medical” or “traumatic”. Videotapes of the resuscitations were used to validate the accuracy of the written record in some centers. Primary outcome measures were return of spontaneous circulation(ROSC), long term survival, and neurologic outcome. Results: 213 patients were enrolled from May 1991 through October 1996. Ages ranged from 3 days to 22 years. 127 patients received HDE (32 trauma patients) and 86 patients received SDE (27 trauma patients). There was no significant difference in age, gender, prehospital intubation rate and prehospital epinephrine use between the HDE and SDE groups. Survivors to discharge included 11/154 medical and 0/59 trauma patients. 33/154 (21%) of medical patients experienced ROSC. ROSC occurred more frequently in the HDE group, 24/95 (25%), than in the SDE group, 9/59 (15%); this trend was not significant(p> 0.10, χ2=2.16). Mean number of doses to achieve ROSC was 3.33 in the HDE group and 3.00 in the SDE group. In the medical group, 9/95(9.5%) HDE patients and 2/59 (3.4%) SDE patients survived to discharge(p=0.134, Fisher's exact test). 8/11 long term survivors were vegetative or suffered severe neurologic outcome as defined by the Glasgow Outcome Scale(2/2 in the SDE group and 6/9 in the HDE group.) The difference in neurologically intact survivors was not significant between the two groups(p=0.24, Fisher's exact test). There was no significant difference in ROSC in the HDE versus SDE trauma patients. Conclusion: Long term survival and neurologic outcome are poor in CPA. The use of HDE does not significantly improve the outcome when compared to SDE." @default.
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• W2000209851 date "1998-04-01" @default.
• W2000209851 modified "2023-09-26" @default.
• W2000209851 title "High Dose Epinephrine (HDE) in Pediatric Cardiopulmonary Arrest (CPA) • 387" @default.
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• W2000209851 doi "https://doi.org/10.1203/00006450-199804001-00408" @default.
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