A 3-month-old infant weighing 6 kg with congenital heart disease has SpO2 88% and cyanotic nailbeds. What adenosine dose should you administer IV push?

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Multiple Choice

A 3-month-old infant weighing 6 kg with congenital heart disease has SpO2 88% and cyanotic nailbeds. What adenosine dose should you administer IV push?

Adenosine dosing in infants is based on body weight and given as a rapid IV push to terminate narrow-complex SVT. The standard initial dose is 0.1 mg per kilogram, delivered quickly (followed by a saline flush). If there’s no response within a few seconds, a second dose of 0.2 mg/kg can be given. For a 6 kg infant, the initial dose should be 0.6 mg. The other options don’t fit the weight-based rule: 0.06 mg is far too small to achieve the needed AV nodal blockade; 2 mg and 6 mg are higher than the weight-based first dose (they would be excessively large for a 6 kg baby and are not the recommended initial amount). If needed after the first dose, the second dose would be 0.2 mg/kg (about 1.2 mg for this infant), not a fixed higher amount.

Adenosine dosing in infants is based on body weight and given as a rapid IV push to terminate narrow-complex SVT. The standard initial dose is 0.1 mg per kilogram, delivered quickly (followed by a saline flush). If there’s no response within a few seconds, a second dose of 0.2 mg/kg can be given. For a 6 kg infant, the initial dose should be 0.6 mg.

The other options don’t fit the weight-based rule: 0.06 mg is far too small to achieve the needed AV nodal blockade; 2 mg and 6 mg are higher than the weight-based first dose (they would be excessively large for a 6 kg baby and are not the recommended initial amount). If needed after the first dose, the second dose would be 0.2 mg/kg (about 1.2 mg for this infant), not a fixed higher amount.

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