Pharmacology of pediatric resuscitation

Henry Michael Ushay, D. A. Notterman

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The resuscitation of children from cardiac arrest and shock remains a challenging goal. The pharmacologic principles underlying current recommendations for intervention in pediatric cardiac arrest have been reviewed. Current research efforts, points of controversy, and accepted practices that may not be most efficacious have been described. Epinephrine remains the most effective resuscitation adjunct. High-dose epinephrine is tolerated better in children than in adults, but its efficacy has not received full analysis. The preponderance of data continues to point toward the ineffectiveness and possible deleterious effects of overzealous sodium bicarbonate use. Calcium chloride is useful in the treatment of ionized hypocalcemia but may harm cells that have experienced asphyxial damage. Atropine is an effective agent for alleviating bradycardia induced by increased vagal tone, but because most bradycardia in children is caused by hypoxia, improved oxygenation is the intervention of choice. Adenosine is an effective and generally well-tolerated agent for the treatment of supraventricular tachycardia. Lidocaine is the drug of choice for ventricular dysrhythmias, and bretylium, still relatively unexplored, is in reserve. Many pediatricians use dopamine for shock in the postresuscitative period, but epinephrine is superior. Most animal research on cardiac arrest is based on models with ventricular fibrillation that probably are not reflective of cardiac arrest situations most often seen in pediatrics.

Original languageEnglish (US)
Pages (from-to)207-234
Number of pages28
JournalPediatric Clinics of North America
Volume44
Issue number1
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Heart Arrest
Resuscitation
Pharmacology
Pediatrics
Epinephrine
Bradycardia
Shock
Calcium Chloride
Sodium Bicarbonate
Supraventricular Tachycardia
Hypocalcemia
Ventricular Fibrillation
Lidocaine
Atropine
Adenosine
Dopamine
Therapeutics
Research
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pharmacology of pediatric resuscitation. / Ushay, Henry Michael; Notterman, D. A.

In: Pediatric Clinics of North America, Vol. 44, No. 1, 1997, p. 207-234.

Research output: Contribution to journalArticle

Ushay, Henry Michael ; Notterman, D. A. / Pharmacology of pediatric resuscitation. In: Pediatric Clinics of North America. 1997 ; Vol. 44, No. 1. pp. 207-234.
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