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Clifton R. Lacy, MD; John B. Kostis, MD
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School New Brunswick

JAMA. 1989;261(7):989.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

We read with interest the recent article entitled "Successful Resuscitation From Cardiac Arrest Using High-Dose Epinephrine Therapy."1 We agree with the authors' recommendation that further investigation be conducted to determine the optimal dosing of epinephrine in treating patients with cardiac arrest. However, we disagree that their patients "failed to respond" to conventional epinephrine therapy.

Patient 1 was in ventricular fibrillation (VF) when given her first 1-mg intravenous dose of epinephrine ten minutes after arrest. Defibrillation did not change the rhythm. Following administration of lidocaine, the patient developed asystole. At 13 minutes after arrest, another 1-mg intravenous epinephrine dose was administered, and junctional bradycardia as well as spontaneous respiratory movements were noted. There were no palpable pulses, and the rhythm deteriorated into VF. On two subsequent occasions, epinephrine (in 5-mg intravenous doses) apparently facilitated defibrillation to bradycardic junctional rhythm—the first time deteriorating into VF and the second . . . [Full Text PDF of this Article]

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