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Pediatric emergency care · Jun 2020
Case ReportsEpinephrine at 25°C Core Body Temperature and During Rewarming: Case Report of Successful Infant Resuscitation After Cold Water Submersion.
- Christian Mann, Walter Baer, and Thomas Riedel.
- From the Kantonsspital Graubünden, Chur, Switzerland.
- Pediatr Emerg Care. 2020 Jun 1; 36 (6): e346-e348.
AbstractEpinephrine plays a controversial role in accidental hypothermia (<30°C). We report its use in the advanced life support of a 13-month-old white girl with pulseless electrical activity and 25°C core body temperature after 32 minutes of submersion in a fast-running Swiss mountain stream at 8°C. Two doses of epinephrine (10 μg/kg) were given in the field, followed by 12 doses (10 μg/kg) and an infusion of 0.1 μg/kg per minute during rewarming. Spontaneous circulation returned at 29.5°C after 2.5 hours of cardiopulmonary resuscitation. Neurologic long-term outcome was excellent. We conclude that in the presence of nonshockable rhythm the benefits of epinephrine may outweigh the risks of side effects when used in pediatric advanced life support for accidental hypothermia.
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