Cardiac arrest & resuscitation
Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study*
An erratum to this article was published (Crit Care Med, 1 Nov 2024 ↗)
Primary result · Survival to discharge with favorable neurologic outcome (Pediatric Cerebral Performance Category 1-2 or no change from baseline)Result — go to the resultARR for survival with favorable neurologic outcome 1.10 95% CI 0.84–1.46Authors' conclusion
In patients receiving at least two doses of epinephrine, dosing intervals less than 3 minutes were not associated with neurologic outcome but were associated with sustained ROSC and shorter CPR duration.
Study context
- Population
- Children ≤18 years (≥37 weeks corrected gestational age) with index in-hospital cardiac arrest receiving ≥2 doses of epinephrine, 18 US PICUs and pediatric cardiac ICUs; excluded ECPR or dosing intervals >8 minutes
- Participants
- 382 children
- Comparison
- Epinephrine dosing interval <3 vs ≥3 minutes
- Primary endpoint
- Survival to discharge with favorable neurologic outcome:
- Pediatric Cerebral Performance Category 1-2
- No change from baseline
- Follow-up
- Discharge
Methodological detailsmulticentre
- Multicentre
Primary result
As reported in the abstract
ARR for survival with favorable neurologic outcome
1.10
95% CI 0.84–1.46
P = 0.48
<3 min vs ≥3 min
aRR for survival with favorable neurologic outcome 1.10 (95% CI 0.84–1.46); P = 0.48
Further findings
| Outcome | aRR for sustained ROSC (95% CI) | P value | |
|---|---|---|---|
| Sustained ROSC<3 min vs ≥3 min · adjusted for confounders | 1.21 (1.07–1.37) | P < 0.01 | |
| 0.512ARR for sustained ROSC (log scale) |
| Outcome | Adjusted effect estimate (min) (95% CI) | P value |
|---|---|---|
| CPR duration<3 min vs ≥3 min | −9.5 (−14.4 to −4.84) | P < 0.01 |
Original publication
Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study*. Crit Care Med. Published 4 June 2024. doi:10.
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