ArticleCritical care (London, England)2023
The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes.
Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02837497 (Improving Outcomes After Pediatric Cardiac Arrest), which is not on this map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Outcomes After Pediatric Cardiac Arrest
Who cites it
21 citing papers in PubMed, 39 citations in OpenAlex.
- Association of Early Epinephrine with Hemodynamics and Outcome in Pediatric In-Hospital Cardiac Arrest: A Secondary Analysis of a Multicenter, Cluster-randomized Clinical Trial Intensive Care Unit Resuscitation (ICU-RESUS).Annals of the American Thoracic Society · 2025Trial
- Early bolus epinephrine administration during pediatric cardiopulmonary resuscitation for bradycardia with poor perfusion: an ICU-resuscitation study.Critical care (London, England) · 2024Trial
- Outcomes and characteristics of cardiac arrest in children with pulmonary hypertension: A secondary analysis of the ICU-RESUS clinical trial.Resuscitation · 2023Trial
- Comparison of vasopressin to epinephrine during pediatric in-hospital cardiac arrest: survival and physiologic responsiveness.Pediatric research · 2026Article
- Randomised trial of early rapid saline bolus versus epinephrine during resuscitation in perinatal haemorrhagic cardiac arrest in newborn lambs.Archives of disease in childhood. Fetal and neonatal edition · 2026Article
- Physiologic response to sodium bicarbonate administration during pediatric in-hospital cardiac arrest.Frontiers in medicine · 2026Article
- Cardiac Arrest Pharmacopeia: A Personalized Approach to Drug Administration During Cardiopulmonary Resuscitation.Critical care clinics · 2026Review
- Intubation Trends and Survival in Pediatric In-Hospital Cardiac Arrest.JAMA network open · 2025Article
- Bradycardia with haemodynamic compromise in children: A scoping review.Resuscitation plus · 2025Review
- Prearrest vital sign abnormalities are associated with adverse outcomes in pediatric ICU cardiac arrest: a get with the guidelines-resuscitation analysis.Resuscitation · 2025Article
- The Latest in Resuscitation Research: Highlights From the 2024 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2025Article
- Predictors of response to peri-arrest bolus epinephrine in children.Resuscitation plus · 2025Article
- Evaluation of coronary perfusion pressure and diastolic blood pressure calculation methods in a swine model of pediatric cardiopulmonary resuscitation.Resuscitation plus · 2025Article
- The Latest in Resuscitation Research: Highlights From the 2023 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2025Article
- Association of diastolic blood pressure with coronary perfusion pressure during resuscitation in pediatric swine.Pediatric research · 2025Article
- Cardiopulmonary resuscitation employing only abdominal compressions in infants after cardiac surgery: A secondary sub-analysis of the ICU-RESUS study.Resuscitation plus · 2024Article
- Wolf Creek XVII part 9: Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award.Resuscitation plus · 2024Review
- Associations Between End-Tidal Carbon Dioxide During Pediatric Cardiopulmonary Resuscitation, Cardiopulmonary Resuscitation Quality, and Survival.Circulation · 2024Observational
- Hemodynamic Effect of Repeated Epinephrine Doses Decreases With Cardiopulmonary Resuscitation Cycle Progression.Journal of the American Heart Association · 2024Article
- Identification of post-cardiac arrest blood pressure thresholds associated with outcomes in children: an ICU-Resuscitation study.Critical care (London, England) · 2023Article
Corrections and comments
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Authors and funding
15 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundEpinephrine is provided during cardiopulmonary resuscitation (CPR) to increase systemic vascular resistance and generate higher diastolic blood pressure (DBP) to improve coronary perfusion and attain return of spontaneous circulation (ROSC). The DBP response to epinephrine during pediatric CPR and its association with outcomes have not been well described. Thus, the objective of this study was to measure the association between change in DBP after epinephrine administration during CPR and ROSC.
methodsThis was a prospective multicenter study of children receiving ≥ 1 min of CPR with ≥ 1 dose of epinephrine and evaluable invasive arterial BP data in the 18 ICUs of the ICU-RESUS trial (NCT02837497). Blood pressure waveforms underwent compression-by-compression quantitative analysis. The mean DBP before first epinephrine dose was compared to mean DBP two minutes post-epinephrine. Patients with ≥ 5 mmHg increase in DBP were characterized as "responders."
resultsAmong 147 patients meeting inclusion criteria, 66 (45%) were characterized as responders and 81 (55%) were non-responders. The mean increase in DBP with epinephrine was 4.4 [- 1.9, 11.5] mmHg (responders: 13.6 [7.5, 29.3] mmHg versus non-responders: - 1.5 [- 5.0, 1.5] mmHg; p < 0.001). After controlling for a priori selected covariates, epinephrine response was associated with ROSC (aRR 1.60 [1.21, 2.12]; p = 0.001). Sensitivity analyses identified similar associations between DBP response thresholds of ≥ 10, 15, and 20 mmHg and ROSC; DBP responses of ≥ 10 and ≥ 15 mmHg were associated with higher aRR of survival to hospital discharge and survival with favorable neurologic outcome (Pediatric Cerebral Performance Category score of 1-3 or no worsening from baseline).
conclusionsThe change in DBP following epinephrine administration during pediatric in-hospital CPR was associated with return of spontaneous circulation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.