Goetting M G, Paradis N A
Department of Pediatrics, Henry Ford Hospital, Detroit, MI 48202.
Crit Care Med. 1989 Dec;17(12):1258-62. doi: 10.1097/00003246-198912000-00004.
Cardiac arrest has a poor prognosis, regardless of age group. Children who fail to respond to two standard doses of epinephrine (0.01 mg/kg) rarely survive to hospital discharge, and most die without the return of spontaneous circulation (ROSC). We treated seven consecutive children in cardiac arrest with high dose epinephrine (0.2 mg/kg) after failure to respond to two standard doses. Six had prompt and sustained ROSC. By comparison, in the previous 20 consecutive pediatric patients with cardiac arrest in which there was no response to two standard doses of epinephrine, none had ROSC. Previous animal data as well as anecdotal human experience suggest that the standard epinephrine dose (0.01 mg/kg) may be much too low.
心脏骤停的预后较差，与年龄组无关。对两剂标准剂量肾上腺素（0.01mg/kg）无反应的儿童很少能存活至出院，大多数在未恢复自主循环（ROSC）的情况下死亡。在对两剂标准剂量无反应后，我们用大剂量肾上腺素（0.2mg/kg）连续治疗了7名心脏骤停儿童。其中6名迅速并持续恢复了自主循环。相比之下，在之前连续20例对两剂标准剂量肾上腺素无反应的儿科心脏骤停患者中，无人恢复自主循环。以往的动物数据以及零散的人类经验表明，标准肾上腺素剂量（0.01mg/kg）可能过低。
