Monitoring of brain tissue oxygen tension and use of vasopressin after cardiac arrest in a child with catecholamine-induced cardiac arrhythmia.
A 14-year-old boy with catecholamine-induced polymorphic ventricular tachycardia was treated for hypoxic brain injury after a 25-minute ventricular tachycardia arrest. He had been treated by the local paediatric cardiology service with ?-blockers for syncopal events related to episodes of ventricular tachycardia. As standard inotropic support was contraindicated, he was treated for hypoxic brain injury, with targeting of brain tissue oxygen levels (PtO2) with vasopressin. He was extubated after 7 days and discharged home with an automatic implantable cardioverter defibrillator, with no neurological sequelae. PtO2 is a reliable and effective clinical assessment tool that can aid in the management of patients with significant cerebral injury. Vasopressin proved a valuable adjunct in treatment of hypoxic brain injury when inotropic agents were contraindicated.
Cavazzoni
Elena
E
Children's Hospital at Westmead, Sydney, NSW. ecavazzoni@gmail.com
Schibler
Andreas
A
D000293:Adolescent; D001921:Brain / Q000378:metabolism; D002395:Catecholamines / Q000502:physiology*; D006323:Heart Arrest / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*
D002395:Catecholamines; D014662:Vasoconstrictor Agents; D014667:Vasopressins