Update on pediatric resuscitation drugs: high dose, low dose, or no dose at all.
OBJECTIVE
Pediatric resuscitation has been a topic of discussion for years. It is difficult to keep abreast of changing recommendations, especially for busy pediatricians who do not regularly use these skills. This review will focus on the most recent guidelines for resuscitation drugs.


RESULTS
Three specific questions will be discussed: standard dose versus high-dose epinephrine, amiodarone use, and the future of vasopressin in pediatric resuscitation. The issue of using high-dose epinephrine for cardiopulmonary resuscitation refractory to standard dose epinephrine has been a topic of debate for many years. Recently, a prospective, double-blinded study was performed to help settle the debate. These results will be reviewed and compared with previous studies. Amiodarone is a medication that was added to the pediatric resuscitation algorithms with the most recent recommendations from the American Heart Association in 2000. Its use and safety will also be discussed. Another topic that is resurfacing in resuscitation is the use of vasopressin. Its mechanism and comparisons to other agents will be highlighted, although its use in the pediatric patient has not been thoroughly studied.


CONCLUSIONS
Pediatric resuscitation is a constantly evolving subject that is on the mind of anyone taking care of sick children. Clinicians are continually searching for the most effective methods to resuscitate children in terms of short- and long-term outcomes. It is important to be familiar with not only the agents being used but also the optimal way to use them.
Sorrentino
Annalise
A
Division of Emergency Medicine, University of Alabama-Birmingham, Birmingham, Alabama 35233, USA. asorrentino@peds.uab.edu
D000322:Adrenergic Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000638:Amiodarone / Q000008:administration & dosage / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards*; D002648:Child; D002986:Clinical Trials as Topic; D004305:Dose-Response Relationship, Drug; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D017410:Practice Guidelines as Topic; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014667:Vasopressins / Q000008:administration & dosage / Q000627:therapeutic use
D000322:Adrenergic Agonists; D000889:Anti-Arrhythmia Agents; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D000638:Amiodarone; D004837:Epinephrine