{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:25:12Z","timestamp":1761218712526,"version":"3.40.4"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"name":"TRI SERVICE NURSING RESEARH PROGRAM","award":["N22-A05"],"award-info":[{"award-number":["N22-A05"]}]},{"name":"TRI SERVICE NURSING RESEARH PROGRAM","award":["N22-A05"],"award-info":[{"award-number":["N22-A05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The aims of this study were to compare concentration maximum (Cmax), time to Cmax, area under the curve, mean concentration over 4\u2009minutes, and frequency and time to return of spontaneous circulation (ROSC) by group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective, experimental study using swine. In total, 40 pigs (n\u2009=\u20098 per group) were assigned as follows: 0.1\u2009mg\/kg endotracheal (ET) tube, 1\u2009mg intravenous (IV), 2\u2009mg ET, Cardio Pulmonary Resuscitation (CPR)\u2009+\u2009defibrillation (CPR\u2009+\u2009defib), and CPR-Only. Pigs were placed in arrest for 2\u2009minutes, CPR was then initiated for 2\u2009minutes, and epinephrine was then administered and repeated every 4\u2009minutes or until ROSC. Blood samples were collected over 4\u2009minutes. Defibrillation was initiated at 3\u2009minutes and continued every 2\u2009minutes for 30\u2009minutes or until ROSC. CPR\u2009+\u2009defib and CPR-Only Groups served as controls. The CPR\u2009+\u2009defib Group had defibrillations but did not receive epinephrine. The CPR-Only Group did not receive defibrillations or epinephrine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results and Conclusions<\/jats:title>\n                  <jats:p>The Cmax and area under the curve were significantly higher in the IV Group compared to the 0.1\u2009mg\/kg ET Group (P\u2009&amp;lt;\u2009.05). The time to Cmax was significantly longer in the 0.1\u2009mg\/kg Group than the 1\u2009mg IV Group (P\u2009=\u2009.03). The mean concentration of the 1\u2009mg IV Group was higher than the 0.1\u2009mg\/kg ET Group until 180 and 240\u2009seconds. There was no significant difference between the groups relative to time to ROSC (P\u2009&amp;gt;\u2009.05). Return of spontaneous circulation frequencies were: 0.1\u2009mg\/kg ET Group (7 of 8); 1\u2009mg IV Group (5 of 8); and 2\u2009mg ET Group (1 of 8), and both CPR\u2009+\u2009defib and CPR-Only (0 out of 8). This study challenges the current guidelines relative to ET epinephrine administration. Based on our ROSC data, the 0.1\u2009mg\/kg dose of epinephrine by ET should be used as a first-line intervention.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaf026","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T15:25:46Z","timestamp":1738596346000},"page":"e1045-e1051","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Endotracheal Weight-Based Epinephrine on Pharmacokinetics and Survival in Swine With a Cardiac Arrest"],"prefix":"10.1093","volume":"190","author":[{"given":"Don","family":"Johnson","sequence":"first","affiliation":[{"name":"The Geneva Foundation , Tacoma, Washington 98402,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Blouin","sequence":"additional","affiliation":[{"name":"The Geneva Foundation , Tacoma, Washington 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