Role of drug therapy in pediatric resuscitation

What role does drug therapy play in pediatric resuscitation? 

Drug therapy during resuscitation is reserved for patients who do not respond adequately to the ABCs. Other than oxygen, most pediatric resuscitations require few drugs. Other useful chemical agents include the following:

  • • Epinephrine (to increase heart rate, myocardial contractility, and systemic vascular resistance)
  • • Atropine (to increase heart rate in nonneonates)
  • • Dextrose (to increase glucose)
  • • Amiodarone or procainamide (to reverse ventricular arrhythmias)
  • • Naloxone (to reverse the effects of narcotics)
  • • Adenosine (to reverse supraventricular tachycardia)
  • • Dopamine (to increase vasoconstriction and blood pressure)
  • • Dobutamine (to increase myocardial contractility)
  • • Benzodiazepines (to achieve sedation and control seizures)

Keep in mind that administration of any of these drugs should never be considered as a first line of management for any situation. During resuscitation, drug therapy should always be preceded by another intervention. Oxygenation and ventilation are always the first priorities for any seriously ill child. Other appropriate supportive measures (e.g., chest compressions for pulselessness or fluid infusion for shock) should also precede administration of drugs during resuscitation. Note: There is insufficient evidence to support the routine use of atropine in pediatric cardiac arrest.


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