Renal failure and other serious sequelae of epinephrine toxicity in neonates

Epinephrine has numerous potent pharmacologic actions with protean manifestations. We have described a patient in whom inadvertent intra-aortic administration of a large dose of racemic epinephrine produced serious adverse effects, including hypertension, acidemia, tachycardia, and protracted but reversible renal failure. In view of the ubiquitous use of epinephrine in neonatal intensive care, we hope that this report heightens awareness of its more serious and potentially fatal toxic effects.