REVIEW   

Minerva Pediatrica 2019 April;71(2):159-73

DOI: 10.23736/S0026-4946.18.05452-X

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Evidence for vasopressors during cardiopulmonary resuscitation in newborn infants

Megan O'REILLY ^{1, 2}, Georg M. SCHMÖLZER ^{1, 2} ✉

¹ Center for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Canada; ² Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

An estimated 0.1% of term infants and up to 15% of preterm infants (2-3 million worldwide) need extensive resuscitation, defined as chest compression and 100% oxygen with or without epinephrine in the delivery room. Despite these interventions, infants receiving extensive resuscitation in the DR have a high incidence of mortality and neurologic morbidity. Successful resuscitation from neonatal cardiac arrest requires the delivery of high-quality chest compression using the most effective vasopressor with the optimal dose, timing, and route of administration during CPR. Current neonatal resuscitation guidelines recommend administration of epinephrine once CPR has started at a dose of 0.01-0.03 mg/kg preferably given intravenously, with repeated doses every 3-5 min until return of spontaneous circulation. This review examines the current evidence for epinephrine and alternative vasopressors during neonatal cardiopulmonary resuscitation.

KEY WORDS: Newborn infant - Resuscitation - Chest wall oscillation - Asphyxia neonatorum - Vasopressins - Heart arrest