Table 1.

Epinephrine use during newborn resuscitation: route, dose, and summary of evidence.

Route	Dose	Summary of evidence
Intravenous	0.01–0.03 mg/kg	Preferred route and appear to be more efficacious than other routes Dose extrapolated from adult experience High-dose epinephrine offers no advantage and is associated with increased postresuscitation adverse effects and increased mortality Dose escalation studies in neonatal animal model with transition physiology are urgently needed
Endotracheal (ET)	0.05–0.1 mg/kg	Less effective than IV route Achieved plasma concentration is less and it peaks slower with ET epinephrine compared to IV epinephrine Can be used until IV access is available
Intraosseous	0.01–0.03 mg/kg	Limited evidence compared to IV route Providers frequently involved in newborn resuscitation feel more comfortable with rapid UVC insertion compared to IO route
Intramuscular	Not recommended	Very limited evidence Significant tissue damage at local site