Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Is epinephrine effective during neonatal resuscitation?

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it


Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Animal models for neonatal resuscitation.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.


  1. Wyckoff, M. H., Weiner, G. M. & Neonatal Life Support Collaborators. 2020 International Consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Pediatrics 147, e2020038505C (2021).

  2. Halling, C., Sparks, J. E., Christie, L. & Wyckoff, M. H. Efficacy of intravenous and endotracheal epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. J. Pediatr. 185, 232–236 (2017).

    Article  CAS  PubMed  Google Scholar 

  3. Andersen, H. B. et al. Epinephrine vs placebo in neonatal resuscitation: ROSC and brain MRS/MRI in term piglets. Pediatr. Res. (2022).

  4. Barber, C. A. & Wyckoff, M. H. Use and efficacy of endotracheal versus intravenous epinephrine during neonatal cardiopulmonary resuscitation in the delivery room. Pediatrics 118, 1028–1034 (2006).

    Article  PubMed  Google Scholar 

  5. Vali, P. et al. Evaluation of timing and route of epinephrine in a neonatal model of asphyxial arrest. J. Am. Heart Assoc. 6, e004402 (2017).

  6. Sankaran, D. et al. Effect of a larger flush volume on bioavailability and efficacy of umbilical venous epinephrine during neonatal resuscitation in ovine asphyxial arrest. Children (Basel) 8, 464 (2021).

  7. Sankaran, D. et al. Randomised trial of epinephrine dose and flush volume in term newborn lambs. Arch. Dis. Child Fetal Neonatal Ed. 106, 578–583 (2021).

  8. Bruckner, M. et al. Assessment of optimal chest compression depth during neonatal cardiopulmonary resuscitation: a randomised controlled animal trial. Arch. Dis. Child Fetal Neonatal Ed. 107, 262–268 (2022).

    Article  PubMed  Google Scholar 

  9. Foglia, E. E. et al. Duration of resuscitation at birth, mortality, and neurodevelopment: a systematic review. Pediatrics 146, e20201449 (2020).

  10. Foglia, E. E. et al. Survival after delivery room cardiopulmonary resuscitation: a national registry study. Resuscitation 152, 177–183 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  11. Roberts, C. T. et al. Comparison of intraosseous and intravenous epinephrine administration during resuscitation of asphyxiated newborn lambs. Arch. Dis. Child Fetal Neonatal Ed. 107, 311–316 (2022).

    Article  PubMed  Google Scholar 

  12. Vali, P., Weiner, G. M., Sankaran, D. & Lakshminrusimha, S. What is the optimal initial dose of epinephrine during neonatal resuscitation in the delivery room? J. Perinatol. 41, 1769–1773 (2021).

  13. Laptook, A. R. et al. Outcome of term infants using Apgar scores at 10 min following hypoxic-ischemic encephalopathy. Pediatrics 124, 1619–1626 (2009).

    Article  PubMed  Google Scholar 

  14. Hagihara, A. et al. Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA 307, 1161–1168 (2012).

    Article  CAS  PubMed  Google Scholar 

  15. Mike, J. K. et al. An ovine model of perinatal hypoxic-ischemic encephalopathy with resultant motor impairment aimed at low resource settings. Dev. Neurosci. (2022).

Download references


This work was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 5 R01 HD072929 09 (S.L.), and research grant from the American Academy of Pediatrics-Neonatal Resuscitation Program (D.S.), and Children’s Miracle Network at UC Davis Pediatrics (D.S.).

Author information

Authors and Affiliations



D.S. and S.L. made substantial contributions to the conception and design, data acquisition, and interpretation of data and drafting the manuscript. E.J.M. made substantial contributions to the concept, design, editing and revising the manuscript. All authors critically revised and approved the final version for publication.

Corresponding author

Correspondence to Deepika Sankaran.

Ethics declarations

Competing interests

The named authors have no conflict of interest, financial or otherwise. S.L. is a member of the American Academy of Pediatrics (AAP), Neonatal Resuscitation Steering Committee (NRP). Views expressed in this manuscript are those of authors and do not reflect the official position of AAP/NRP.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sankaran, D., Molloy, E.J. & Lakshminrusimha, S. Is epinephrine effective during neonatal resuscitation?. Pediatr Res 93, 466–468 (2023).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


Quick links