Pediatric anesthesia & critical care
Epinephrine dosing strategies during pediatric extracorporeal cardiopulmonary resuscitation reveal novel impacts on survival: A multicenter study utilizing time-stamped epinephrine dosing records
Main finding · Adjusted survivalResult — go to the resultOdds ratio 0.78 95% CI 0.36–1.69Authors' conclusion
Survivors received fewer doses than non-survivors after the first 10 minutes of CPR and although there was no statistical difference in survival based on dosing strategy, the findings of this study question the conventional approach to EPCR analysis that assumes dosing is evenly distributed.
Study context
- Population
- Children <18 years with an in-hospital ECPR event
- Participants
- 191 children
- Exposure
- Frequent vs limited epinephrine dosing strategy during ECPR
- Outcome
- Survival
Methodological detailsmulticentre, 5 pediatric hospitals, time-stamped epinephrine dosing records
- Multicentre
- 5 pediatric hospitals
- Time-stamped epinephrine dosing records
Main finding
Adjusted survival
Odds ratio
0.78
95% CI 0.36–1.69
P = 0.53
Frequent epinephrine vs Limited epinephrine
OR 0.78 (95% CI 0.36–1.69); P = 0.53
As reported in the abstract
Observational data: associations, not effects.
Further findings
Epinephrine dose distribution during ECPR
- Doses given during the first half of the event
- 66%
Mean number of epinephrine doses, survivors vs non-survivors
- Similar in first 10 minutes
- 2.7 doses
- After 10 minutes, survivors received fewer doses than non-survivors in each subsequent 10-minute interval
Original publication
Epinephrine dosing strategies during pediatric extracorporeal cardiopulmonary resuscitation reveal novel impacts on survival: A multicenter study utilizing time-stamped epinephrine dosing records. Resuscitation. Published 29 May 2023. doi:10.
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