One child died during intubation who had not received atropine.Ītropine significantly reduced the prevalence of new arrhythmias during intubation particularly for children over 1 month of age, did not convert sinus tachycardia to ventricular tachycardia or fibrillation, and may contribute to the safety of intubation. In this paper, we present a symptomatic patient with a concealed form of SND, in whom atropine testing yielded a junctional rhythm with a nearly total disappearance of premature ventricular complexes (PVCs). Only one ventricular escape rhythm occurred in the atropine group (n = 152) in a child with an abnormal heart. Acute bundle branch block was observed during three intubations one Mobitz type 2 rhythm and five ventricular escape rhythms occurred in the no-atropine group (n = 170). The most common new arrhythmia was junctional rhythm. New arrhythmias during intubation were related to bradycardia and were less common with atropine use (odds ratio, 0.14, p < 0.001). Atropine was used in 47% (152/322) of intubations and resulted in significant acceleration of heart rate without provoking ventricular arrhythmias. Five children (1.5%) had arrhythmias prior to intubation and were excluded from the atropine analysis. Subgroups of intubations with and without atropine were analyzed.Ī total of 414 intubations were performed in the study period of which 327 were available for analysis (79%). atropine until pacemaker can be inserted (cardiac pacing) - defib close. When there is significant sinus bradycardia, a slow junctional escape rhythm or a slow atrial rhythm originating from an ectopic focus can be present. Slow heart rates can be observed during sleep or at times of high vagal tone. PICU and pediatric/neonatal intensive care transport.Īll children of age less than 8 years intubated September 2007-2009. Sinus bradycardia is characterized by sinus rhythm with heart rates below normal for age (see Fig. Our objectives were to describe the prevalence of arrhythmia and conduction abnormalities before critical care intubation and to test the hypothesis that atropine had no effect on their prevalence during intubation.
0 Comments
Leave a Reply. |
Details
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |