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Pitfalls in the use of adenosine
  1. E Rosenthal
  1. Evelina Children’s Hospital, Lambeth Palace Road, London SE1 7EH, UK;

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The report by Dixon et al. on the dosing of adenosine is important.1 That the use of higher starting doses (100–200 μg/kg) should significantly increase the chance of adenosine terminating the supraventricular tachycardia or demonstrating its mechanism on the first dose was clearly demonstrated in their retrospective review.

It is worth repeating that the maximum dose for children of 500 μg/kg and neonates of 300 μg/kg is for a singly administered dose. An issue that we see far too frequently is the summing of each dose of adenosine to arrive at a cumulative dose that “precludes further administration”. When starting at 50 μg/kg and incrementing …

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  • Competing interests: none declared