title: Bradycardia leading to asystole during dexmedetomidine infusion in an 18 year-old double-lung transplant recipient.
abstract: The case of an 18 year-old double-lung transplant recipient recovering from acute respiratory distress syndrome who developed repeated episodes of bradycardia and asystole (maximum duration: 10 sec) during dexmedetomidine administration is presented. Increased baseline vagal tone, paroxysmal coughing spells, and opioid administration were likely contributors to the episodes. Discontinuation of the drug restored regular sinus rhythm. Double-lung transplant recipients may be at especially increased risk for this phenomenon as a result of changes in the autonomic innervation of the heart.
authors.affiliation: Division of Anesthesiology, Geisinger Medical Center, Danville, PA 17821, USA.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Zhang
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schmidt
authors.forename: John C
authors.initials: JC
authors.lastname: Wain
authors.forename: Luca
authors.initials: L
authors.lastname: Bigatello
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007262:Infusions, Intravenous; D016040:Lung Transplantation
chemical_list: D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine