{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:15:17Z","timestamp":1790381717094,"version":"4.1.0"},"reference-count":21,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["5R01 HD072929"],"award-info":[{"award-number":["5R01 HD072929"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R03HD096510"],"award-info":[{"award-number":["R03HD096510"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K12 HL138052"],"award-info":[{"award-number":["K12 HL138052"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001412"],"award-info":[{"award-number":["UL1TR001412"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"American Academy of Pediatrics- Neonatal Resuscitation Program Research Grant","award":["No number"],"award-info":[{"award-number":["No number"]}]},{"name":"Canadian Pediatric Society- Neonatal Resuscitation Program Research Grant","award":["No number"],"award-info":[{"award-number":["No number"]}]},{"name":"Children's Miracle Network at UC Davis Pediatrics","award":["No number"],"award-info":[{"award-number":["No number"]}]},{"name":"Child Health Research Grant from UC Davis Pediatrics and First Tech Federal Credit Union","award":["No number"],"award-info":[{"award-number":["No number"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>The 7th edition of the Textbook of Neonatal Resuscitation recommends administration of epinephrine via an umbilical venous catheter (UVC) inserted 2\u20134 cm below the skin, followed by a 0.5-mL to 1-mL flush for severe bradycardia despite effective ventilation and chest compressions (CC). This volume of flush may not be adequate to push epinephrine to the right atrium in the absence of intrinsic cardiac activity during CC. The objective of our study was to evaluate the effect of 1-mL and 2.5-mL flush volumes after UVC epinephrine administration on the incidence and time to achieve return of spontaneous circulation (ROSC) in a near-term ovine model of perinatal asphyxia induced cardiac arrest. After 5 min of asystole, lambs were resuscitated per Neonatal Resuscitation Program (NRP) guidelines. During resuscitation, lambs received epinephrine through a UVC followed by 1-mL or 2.5-mL normal saline flush. Hemodynamics and plasma epinephrine concentrations were monitored. Three out of seven (43%) and 12\/15 (80%) lambs achieved ROSC after the first dose of epinephrine with 1-mL and 2.5-mL flush respectively (p = 0.08). Median time to ROSC and cumulative epinephrine dose required were not different. Plasma epinephrine concentrations at 1 min after epinephrine administration were not different. From our pilot study, higher flush volume after first dose of epinephrine may be of benefit during neonatal resuscitation. More translational and clinical trials are needed.<\/jats:p>","DOI":"10.3390\/children8060464","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T23:33:33Z","timestamp":1622504013000},"page":"464","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Effect of a Larger Flush Volume on Bioavailability and Efficacy of Umbilical Venous Epinephrine during Neonatal Resuscitation in Ovine Asphyxial Arrest"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6704-6949","authenticated-orcid":false,"given":"Deepika","family":"Sankaran","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payam","family":"Vali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-3017","authenticated-orcid":false,"given":"Praveen","family":"Chandrasekharan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia F.","family":"Gugino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmon","family":"Koenigsknecht","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Helman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3846-2027","authenticated-orcid":false,"given":"Jayasree","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bobby","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munmun","family":"Rawat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy L.","family":"Lesneski","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Research, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E.","family":"Hardie","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziad","family":"Alhassen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houssam M.","family":"Joudi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0364-0057","authenticated-orcid":false,"given":"Evan M.","family":"Giusto","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, Davis, Sacramento, CA 95817, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lida","family":"Zeinali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University at Buffalo, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather K.","family":"Knych","sequence":"additional","affiliation":[{"name":"Department of Molecular Biosciences, Davis School of Veterinary Medicine, University of California, Davis, CA 95616, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary 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