What is the appropriate infusion dose rate for a 3‑kg infant at 0.1 µg per kilogram per minute?

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Epinephrine Infusion Calculation for 3 kg Infant

For a 3 kg infant receiving epinephrine at 0.1 µg/kg/min, the infusion rate is 0.3 µg/min (or 18 µg/hour).

Calculation Breakdown

  • Dose calculation: 0.1 µg/kg/min × 3 kg = 0.3 µg/min 1

  • Hourly rate: 0.3 µg/min × 60 min = 18 µg/hour 1

Standard Concentration and Volume Calculation

  • The standard epinephrine concentration for continuous infusion is typically 0.1 mg/mL (100 µg/mL) from the 1:10,000 solution 1

  • To deliver 0.3 µg/min: Using a 100 µg/mL concentration, the infusion rate would be 0.18 mL/hour (or 0.003 mL/min) 1

  • Alternative calculation using mg/hour: 0.018 mg/hour ÷ 0.1 mg/mL = 0.18 mL/hour 1

Clinical Context for This Dose

  • This dose (0.1 µg/kg/min) falls within the recommended range for continued shock after volume resuscitation, where the American Academy of Pediatrics recommends starting at 0.1–1.0 µg/kg/min, beginning at the lowest dose and titrating to desired clinical effect 1

  • Doses as high as 5 µg/kg/min are sometimes necessary for refractory shock, but always start low and titrate upward based on clinical response 1

Critical Safety Considerations

  • Extravasation risk: IV infiltration can result in severe skin injury; phentolamine (0.1–0.2 mg/kg up to 10 mg diluted in 10 mL of 0.9% sodium chloride) injected intradermally at the extravasation site may counteract dermal vasoconstriction 1

  • Dose-dependent effects: At this low dose (0.1 µg/kg/min), β-adrenergic effects typically predominate, providing inotropic support; α-adrenergic vasoconstriction becomes more prominent at higher doses 1

  • Monitoring requirements: Continuous cardiac monitoring is essential, as epinephrine may cause tachyarrhythmias, ectopic beats, and blood pressure fluctuations 1

Practical Preparation Tips

  • For a 3 kg infant, a common preparation is 3 mg epinephrine in 50 mL D5W (concentration = 60 µg/mL), which would require an infusion rate of 0.3 mL/hour to deliver 0.1 µg/kg/min 1

  • Always verify the concentration being used at your institution, as preparation methods vary 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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