{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T21:48:14Z","timestamp":1792705694324,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,2,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Epinephrine administered by low umbilical venous catheter (\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              ) or endotracheal tube (\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              ) is indicated in neonates who fail to respond to positive pressure ventilation and chest compressions at birth. Pharmacokinetics of\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              epinephrine via fluid\u2010filled lungs or\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              epinephrine in the presence of fetal shunts is unknown. We hypothesized that epinephrine administered by\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              or low\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              results in plasma epinephrine concentrations and rates of return of spontaneous circulation (\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              ) similar to right atrial (\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              ) epinephrine.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Forty\u2010four lambs were randomized into the following groups:\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              epinephrine (0.03\u00a0mg\/kg), low\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              epinephrine (0.03\u00a0mg\/kg), postcompression\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              epinephrine (0.1\u00a0mg\/kg), and precompression\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              epinephrine (0.1\u00a0mg\/kg). Asystole was induced by umbilical cord occlusion. Resuscitation was initiated following 5\u00a0minutes of asystole. Thirty\u2010eight of 44 lambs achieved\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              (10\/11, 9\/11, and 12\/22 in the\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              ,\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              , and\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              groups, respectively; subsequent\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              epinephrine resulted in a total\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              of 19\/22 in the\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              groups). Median time (interquartile range) to achieve\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              was significantly longer in the\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              group (including those that received\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              epinephrine) compared to the intravenous group (4.5 [2.9\u20137.4] versus 2 [1.9\u20133] minutes;\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              and low\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              epinephrine administration achieved comparable peak plasma epinephrine concentrations (470\u00b1250 versus 450\u00b1190\u00a0ng\/mL) by 1\u00a0minute compared to\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              values of 130\u00b160\u00a0ng\/mL at 5\u00a0minutes;\n              <jats:italic>P<\/jats:italic>\n              =0.03. Following\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              with\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              epinephrine alone, there was a delayed peak epinephrine concentration (652\u00b1240\u00a0ng\/mL).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The absorption of\n              <jats:styled-content style=\"fixed-case\">ETT<\/jats:styled-content>\n              epinephrine is low and delayed at birth.\n              <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>\n              and low\n              <jats:styled-content style=\"fixed-case\">UVC<\/jats:styled-content>\n              epinephrine rapidly achieve high plasma concentrations resulting in\n              <jats:styled-content style=\"fixed-case\">ROSC<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.004402","type":"journal-article","created":{"date-parts":[[2017,2,19]],"date-time":"2017-02-19T01:10:16Z","timestamp":1487466616000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["Evaluation of Timing and Route of Epinephrine in a Neonatal Model of Asphyxial Arrest"],"prefix":"10.1161","volume":"6","author":[{"given":"Payam","family":"Vali","sequence":"first","affiliation":[{"name":"Pediatrics, UC Davis, Sacramento, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Chandrasekharan","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munmun","family":"Rawat","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Gugino","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmon","family":"Koenigsknecht","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Helman","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Jusko","sequence":"additional","affiliation":[{"name":"Pharmaceutical Sciences, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Mathew","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Berkelhamer","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayasree","family":"Nair","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra H.","family":"Wyckoff","sequence":"additional","affiliation":[{"name":"Pediatrics, UT Southwestern, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satyan","family":"Lakshminrusimha","sequence":"additional","affiliation":[{"name":"Pediatrics, SUNY University at Buffalo, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60549-1"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-0416"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2013.08.001"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.10.877"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.07.041"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199912000-00024"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199407000-00021"},{"key":"e_1_3_4_9_2","article-title":"Efficacy of Intravenous and Endotracheal Epinephrine during Neonatal Cardiopulmonary Resuscitation in the Delivery Room","author":"Halling C","unstructured":"Halling C, Sparks JE, Lucy C, Wyckoff MH. Efficacy of Intravenous and Endotracheal Epinephrine during Neonatal Cardiopulmonary Resuscitation in the Delivery Room. J Pediatr. In press.","journal-title":"J Pediatr"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/9781610020275"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2015.117"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00711.2011"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196303000-00008"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199610000-00016"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0300-9572(93)90120-F"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2012.02.029"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032440"},{"key":"e_1_3_4_18_2","unstructured":"Barber C Wyckoff M. Randomized controlled trial of endotracheal versus intravenous administration of epinephrine during neonatal cardiopulmonary resuscitation in asphyxiated piglets. Honolulu HI: E\u2010PAS2008:63445312. 2008."},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000267"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-9572(03)00163-1"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-200106000-00009"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2014.38"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.11.003"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.06.007"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.200386"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2012.10.023"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1990.03440080084029"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2012.09.005"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clp.2011.12.014"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.06.003"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.04.043"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2010.03.004"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004402","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:54:17Z","timestamp":1715597657000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004402"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,2]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2,2]]}},"alternative-id":["10.1161\/JAHA.116.004402"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004402","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,2]]},"assertion":[{"value":"2016-08-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-01-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004402"}}