Use of high-dose epinephrine and sodium bicarbonate during neonatal resuscitation: Is there proven benefit?

Myra H. Wyckoff, Jeffrey M. Perlman

Research output: Contribution to journalReview article

20 Scopus citations

Abstract

For adults and pediatric age patients, high-dose intravenous epinephrine was recommended if standard-dose epinephrine failed to achieve return of spontaneous circulation. More recent trials suggest that high-dose epinephrine is not beneficial and may result in increased harm. There are no randomized clinical studies of high-dose versus standard-dose intravenous epinephrine in neonates. Routine use of high-dose epinephrine during neonatal resuscitation cannot be recommended. Although sodium bicarbonate has been used during neonatal resuscitation, the only randomized controlled trial of its use during brief neonatal resuscitation showed no benefit. Sodium bicarbonate infusion during neonatal cardiopulmonary resuscitation (CPR) has several known and potential side effects. The use of sodium bicarbonate infusion should be discouraged during brief CPR. Whether sodium bicarbonate is beneficial for infants who require prolonged CPR despite adequate ventilation is unknown.

Original languageEnglish (US)
Pages (from-to)141-151
Number of pages11
JournalClinics in Perinatology
Volume33
Issue number1
DOIs
StatePublished - Mar 1 2006

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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