Dose-Related Pharmacokinetic and Pharmacodynamic Effects of Intramuscular Epinephrine in Healthy Neonatal Piglets.

IF 2.1 4区医学 Q2 PEDIATRICS

Children-Basel Pub Date : 2025-09-04 DOI:10.3390/children12091180

Marwa Ramsie, Po-Yin Cheung, Raza Hyderi, Shrieya Praveen, Tze-Fun Lee, Megan O'Reilly, Georg M Schmölzer

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引用次数: 0

Abstract

Background: Epinephrine is currently the only vasopressor recommended during neonatal cardiopulmonary resuscitation (CPR). Rapid vasopressor administration is critical during CPR; however, establishing vascular access can take several minutes and requires extensive skills and/or training. The intramuscular (IM) route provides rapid drug administration and does not require special skills, training, or equipment. We aimed to compare various doses of IM epinephrine to intravascular (IV) epinephrine in a healthy neonatal piglet model.

Method: Fifteen newborn piglets (1-3 days of age) underwent anesthesia, intubation via a tracheostomy, and randomization to 0.02 mg/kg IM epinephrine, 0.1 mg/kg IM epinephrine, or 0.02 mg/kg IV epinephrine. Hemodynamic and cardiac function parameters were continuously recorded throughout the experiment. Blood was collected prior to drug administration and throughout the experiment for pharmacokinetic and pharmacodynamic analysis.

Results: Dose-dependent changes in hemodynamic and cardiac function parameters were observed following IM epinephrine administration. Greater changes were observed with 0.1 mg/kg IM epinephrine, while there were little to no changes with 0.02 mg/kg IM epinephrine. Pharmacokinetic parameters were not different between 0.02 mg/kg IV epinephrine or 0.1 mg/kg IM epinephrine.

Conclusions: IM epinephrine dose of 0.1 mg/kg was more effective in producing systemic hemodynamic and cardiac function changes compared to the lower IM dose 0.02 mg/kg.

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肌肉注射肾上腺素对健康新生仔猪的剂量相关药代动力学和药效学影响。

背景：肾上腺素是目前新生儿心肺复苏（CPR）中唯一推荐的血管加压药物。快速给药血管加压素在心肺复苏术中至关重要；然而，建立血管通路可能需要几分钟，并且需要广泛的技能和/或培训。肌肉注射（IM）途径提供快速给药，不需要特殊的技能，培训或设备。我们的目的是比较不同剂量的IM肾上腺素和血管内（IV）肾上腺素在一个健康的新生仔猪模型。方法：15头新生仔猪（1-3日龄）麻醉，气管切开插管，随机给予0.02 mg/kg IM肾上腺素、0.1 mg/kg IM肾上腺素和0.02 mg/kg IV肾上腺素。在整个实验过程中连续记录血流动力学和心功能参数。在给药前和整个实验过程中采集血液进行药代动力学和药效学分析。结果：注射肾上腺素后血流动力学和心功能参数呈剂量依赖性变化。注射0.1 mg/kg的肾上腺素后观察到更大的变化，而注射0.02 mg/kg的肾上腺素后几乎没有变化。0.02 mg/kg静脉注射肾上腺素和0.1 mg/kg静脉注射肾上腺素的药代动力学参数无显著差异。结论：与较低剂量0.02 mg/kg的IM相比，0.1 mg/kg的IM肾上腺素对全身血流动力学和心功能的改变更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Children-Basel PEDIATRICS-

CiteScore

2.70

自引率

16.70%

发文量

1735

审稿时长

6 weeks

期刊介绍： Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.