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October 3, 1986

Cardiopulmonary Resuscitation-Reply

Author Affiliations

Straub Clinic and Hospital Honolulu

JAMA. 1986;256(13):1724-1725. doi:10.1001/jama.1986.03380130050017

In Reply.—  We appreciate receiving the above correspondence and welcome the opportunity to reply.Dr Neathawk and colleagues and Dr Tek have appropriately indicated that the dosage of sodium nitroprusside as published (10 to 20 mg/min) is much too high. The correction, published in this issue,1 corrects the milligrams to micrograms, which was the original intent. It should now read 10 to 20 μg/min. Product prescribing information states that the dosage range is 0.5 to 10 μg/kg/min, and, assuming a 70-kg victim, the initial dose would be 35 to 700 μg/min. The standards and guidelines clearly recommend a lower initial dose; however, this is consistent with the philosophy adopted for all drug administration in the standards and guidelines. All initial dosages are purposefully on the low side to accommodate a broad range of clinical situations to avoid unnecessary morbidity and unnecessary complications in critical situations. These low initial doses