Efficacy of low-dose epinephrine continuous infusion in neonatal intensive care unit patients

Gloria Lee, Jeffrey R. Kaiser, Brady S. Moffett, Emily Rodman, Cynthia Toy, Danielle R. Rios

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVES Although epinephrine is used in the neonatal intensive care unit, few data exist on efficacy of doses <0.05 mcg/kg/min. This study evaluates the efficacy and safety of low-dose epinephrine continuous infusion at doses <0.05 mcg/kg/min in infants. METHODS Single-center, retrospective review of hypotensive infants from 2011–2018. Charts were reviewed for initial and maximum epinephrine doses, additional vasoactive agents, short-term efficacy, and adverse effects. The primary outcome was percentage of patients initiated on low-dose epinephrine whose dose did not require titration to ≥0.05 mcg/kg/min. RESULTS A total of 115 patients met study criteria with 131 distinct occurrences of low-dose epinephrine initiation. Most patients were unresponsive to other vasopressors at the time of epinephrine initiation. The median (IQR) starting dose of low-dose epinephrine was 0.01 (0.01–0.04) mcg/kg/min and median (IQR) maximum dose was 0.04 (0.02–0.08) mcg/kg/min. Fifty-five percent were responders. Patients in this cohort demonstrated significant improvement of blood pressure and urine output (p < 0.001) without adverse effects. CONCLUSIONS Low-dose epinephrine infusion may be considered as an alternative treatment to standard starting doses in hypotensive neonatal intensive care unit patients. ABBREVIATIONS BP, blood pressure; IV, intravenous; NICU, neonatal intensive care unit; UOP, urine output.

Original languageEnglish (US)
Pages (from-to)51-55
Number of pages5
JournalJournal of Pediatric Pharmacology and Therapeutics
Volume26
Issue number1
DOIs
StatePublished - 2021

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)

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