Table 5.
Cardiovascular adverse events associated with routes of epinephrine administration
| Cardiovascular adverse eventsa | IM injection (n = 0) |
SC injection (n = 2) |
IV bolus (n = 17)b |
|||
|---|---|---|---|---|---|---|
| overdose | nonoverdose | overdose | nonoverdose | over dose | nonoverdose | |
| Hypertension | 0 | 0 | 0 | 0 | 8 (47.1) | 1 (5.9) |
| Arrhythmia | 0 | 0 | 1 (50.0) | 1 (50.0) | 5 (29.4) | 2 (11.8) |
| Ischemia | 0 | 0 | 0 | 0 | 1 (5.9) | 0 |
| Stroke | 0 | 0 | 0 | 0 | 0 | 0 |
| Angina | 0 | 0 | 0 | 0 | 0 | 0 |
Values are presented as numbers (%). We included 349 patients for cardiovascular event analysis, including 71 patients with IM injection, 122 with SC injection, and 156 with IV bolus. IM, intramuscular; SC, subcutaneous; IV, intravenous; cardiovascular adverse events.
The signs and symptoms of cardiovascular complications that developed after epinephrine administration where the onset was temporally related (within several min or noted on the next set of vital signs) to the epinephrine administration.
One patient presented with both hypertension and arrhythmia, and 1 patient presented with both arrhythmia and myocardial ischemia. One pediatric patient presented with arrhythmia. Overall, there was a significant difference regarding the CAE rate in each administration route (χ2 = 16.728, p < 0.001). IV bolus was more likely to be associated with CAE compared to SC injection (p = 0.006) and IM injection (χ2 = 5.835, p = 0.016). There was no significant difference in overdose rates between IM injection and SC injection (p = 0.532).