Premium
Hemodynamic effects of tracheal and intravenous adrenaline in infants with congenital heart anomalies
Author(s) -
Jonmarker C.,
Olsson A.K.,
Jögi P.,
Forsell C.
Publication year - 1996
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1996.tb04562.x
Subject(s) - medicine , anesthesia , heart rate , hemodynamics , blood pressure , mean arterial pressure , epinephrine , cardiopulmonary resuscitation , resuscitation , crossover study , cardiac output , alternative medicine , pathology , placebo
Background: If intravenous access cannot be accomplished during cardiopulmonary resuscitation in children, tracheal administration of 100 μg/kg of adrenaline (ten times greater than the intravenous dose) is recommended. Methods: In a randomized crossover study we recorded 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 μg/kg) and the other tracheally (3μg/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 of 3 μg/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 μg/kg of adrenaline given intravenously.