Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest
| العنوان: | Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest |
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| المؤلفون: | Jayasree Nair, Praveen Chandrasekharan, Ziad Alhassen, Payam Vali, Lori Nielsen, Justin Helman, Houssam M. Joudi, Deepika Sankaran, Heather K Knych, Amy Lesneski, Bobby Mathew, Satyan Lakshminrusimha, Munmun Rawat, Sylvia F. Gugino, Carmon Koenigsknecht, Morgan Hardie, Lida Zeinali, Gary M. Weiner, Evan M. Giusto, Peggy Chen |
| المصدر: | Children, Vol 8, Iss 464, p 464 (2021) Children (Basel, Switzerland), vol 8, iss 6 Children Volume 8 Issue 6 |
| بيانات النشر: | MDPI AG, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Bradycardia, chest compressions, Resuscitation, Physical Injury - Accidents and Adverse Effects, cardiac arrest, Return of spontaneous circulation, Cardiovascular, Pediatrics, Article, RJ1-570, neonatal resuscitation, Neonatal Resuscitation Program, medicine, epinephrine, Asystole, epinephrine concentrations, business.industry, asphyxia, medicine.disease, Perinatal asphyxia, Brain Disorders, flush volume, Epinephrine, Heart Disease, Anesthesia, Pediatrics, Perinatology and Child Health, medicine.symptom, business, Neonatal resuscitation, medicine.drug |
| الوصف: | The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2–4 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite effective ventilation and chest compressions (CC). This volume of flush may not be adequate to push epinephrine to the right atrium in the absence of intrinsic cardiac activity during CC. The objective of our study was to evaluate the effect of 1-mL and 2.5-mL flush volumes after UVC epinephrine administration on the incidence and time to achieve return of spontaneous circulation (ROSC) in a near-term ovine model of perinatal asphyxia induced cardiac arrest. After 5 min of asystole, lambs were resuscitated per Neonatal Resuscitation Program (NRP) guidelines. During resuscitation, lambs received epinephrine through a UVC followed by 1-mL or 2.5-mL normal saline flush. Hemodynamics and plasma epinephrine concentrations were monitored. Three out of seven (43%) and 12/15 (80%) lambs achieved ROSC after the first dose of epinephrine with 1-mL and 2.5-mL flush respectively (p = 0.08). Median time to ROSC and cumulative epinephrine dose required were not different. Plasma epinephrine concentrations at 1 min after epinephrine administration were not different. From our pilot study, higher flush volume after first dose of epinephrine may be of benefit during neonatal resuscitation. More translational and clinical trials are needed. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 2227-9067 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8bff78b7d504830d65e7878ce6d96936 https://www.mdpi.com/2227-9067/8/6/464 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8bff78b7d504830d65e7878ce6d96936 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 22279067 |
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