Rationale and safe use of dilute epinephrine

About our Guests: 

Catherine Ross, MD, is a pediatric critical care physician in the Division of Medical Critical Care at Boston Children’s Hospital (BCH) and Assistant Professor at Harvard Medical School. She serves on the joint American Heart Association (AHA) and American Academy of Pediatrics national writing group for Pediatric Advanced Life Support 2025 guidelines as well as the AHA Emergency Cardiovascular Care Science Subcommittee and Pediatric Emphasis Group. Her research interests lie in pediatric resuscitation, specifically in designing and implementing high-quality randomized controlled trials in the pre- and intra-arrest periods. Specific areas of interest include peri-arrest bolus epinephrine, intra-arrest drug management, and massive pulmonary embolism in children.

Ryan Morgan is a pediatric intensivist and Associate Professor at the Children’s Hospital of Philadelphia, where he is the Associate Director of the CHOP Resuscitation Science Center and the Associate Division Chief for Faculty Affairs. He was a writing group member for the 2025 AHA/AAP PALS Guidelines and currently serves on the International Liaison Committee on Resuscitation’s Pediatric Life Support Task Force. Ryan's research focuses on intra-arrest physiology and on using physiology to guide resuscitation therapies. He is currently leading PEDICA, an NHLBI-funded study underway across 22 hospitals in the pediRES-Q network examining the physiologic effects of epinephrine during pediatric cardiac arrest.

Selected References: 

1. Cardiac Arrest Pharmacopeia, Critical Care Clinics, 2025
2. Peri-arrest bolus epinephrine practices amongst pediatric resuscitation experts - PMC Resusc Plus. 2022 
3. Physiologic response to pre-arrest bolus dilute epinephrine in the pediatric intensive care unit - PMC Resuscitation. 2018 
4. The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes - PubMed Crit Care. 2023 
5. Comparison of vasopressin to epinephrine during pediatric in-hospital cardiac arrest: survival and physiologic responsiveness - PubMed Pediatric Research. 2025
6. Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study - PubMed. Crit Care Med. 2024

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Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at [email protected].  You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!