Evaluation of Heart-Rate Response Following Atropine Administration During Bradycardic Events in Infants: Fixed Minimum Dose Versus Weight-Based Dose.

OBJECTIVE

The purpose of this study was to compare the change in heart rate (HR) in patients less than 5 kg who received either the fixed minimum dose of atropine (0.1 mg) or the weight-based dose of atropine (0.02 mg/kg).

METHODS

This was a retrospective, single organization, dual-site cohort study of infants less than 5 kg who received atropine in the setting of a bradycardic event from January 1, 2014 to December 31, 2024. Patients were excluded if they received atropine for any other indication. Age at the time of atropine administration, gender, race, weight, and department location within the hospital, mean arterial pressure, and other resuscitative medications were collected.

RESULTS

A total of 36 atropine doses (representing 33 unique patients) met study inclusion. Twenty-seven administration events (75%) were provided as a weight-based dose with no minimum while 9 administration events (25%) were provided as a minimum dose of 0.1 mg. The mean change in HR from time of atropine administration to 5 minutes after atropine was 53.9 ± 37.7 beats per minute for patients who received the weight-based dose of atropine compared with 50.4 ± 18.4 beats per minute for patients who received the minimum dose of atropine (p = 0.864).

CONCLUSIONS

Heart rate response following intravenous atropine to infants less than 5 kg at either 0.02 mg/kg or a minimum dose of 0.1 mg did not statistically differ.