title: [Accidental administration of racemic adrenaline. Three life-threatening cases after intravenous injection in children].
abstract: The inhalation of racemic adrenalin is an important part of the treatment of inflammatory airway obstruction in children. In Norway during the last few years there have been several cases of adrenal solutions intended only for inhalation being accidentally administered as intravenous injections. The solution for inhalation contains an adrenalin concentration 110 times greater than the adrenalin intended for emergency use (0.1 mg/ml). The instant consequences of intravenous injections of inhalation adrenalin include arterial hypertension followed by hypotension, cardiac ischemia and cardiac insufficiency, pulmonary oedema, and respiratory failure and the need for artificial ventilation. The clinical picture in the three patients we describe was very dramatic. The injected doses were 0.16-1.1 mg l-adrenalin per kg body weight. All children survived without sequelae. In order to reduce the risk of accidentally administering intravenous injections of adrenalin intended for inhalation a set of guidelines is being proposed.
authors.affiliation: Barneavdelingen, Sentralsykehuset i Akershus, Nordbyhagen.
authors.forename: B
authors.initials: B
authors.lastname: Zeller
authors.forename: H J
authors.initials: HJ
authors.lastname: Bangstad
mesh_terms: D002648:Child; D004630:Emergencies; D004837:Epinephrine / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008173:Lung Diseases, Obstructive / Q000188:drug therapy; D008297:Male; D008508:Medication Errors; D009330:Nebulizers and Vaporizers; D064705:Racepinephrine
chemical_list: D064705:Racepinephrine; D004837:Epinephrine
vernacular_title: Feiladministrering av racemisk adrenalin. Tre livstruende tilfeller etter intravenøs injeksjon hos barn.