Intraosseous infusion is unreliable for adenosine delivery in the treatment of supraventricular tachycardia.
Supraventricular tachycardia (SVT) is a common tachyarrhythmia in the pediatric population that can necessitate immediate treatment. Adenosine has been well studied as a mainstay treatment, but the methods of adenosine administration have not been very well delineated. The intraosseous technique has presented itself as a possible method of administration. We describe 2 cases in which adenosine was administered through bone marrow infusion to convert SVT without success. The cases we describe show that intraosseous is not a reliable method of administering adenosine to stop SVT. Both patients presented with SVT refractory to vagal maneuvers and difficult intravenous placement. Intraosseous access was achieved, but administration of adenosine at increasing doses was unable to successfully convert the arrhythmia.
Baystate Medical Center, Springfield, MA 01199, USA. ian.goodman@bhs.org
Ian Scott
IS
Goodman
Christina Jennifer
CJ
Lu
D000241:Adenosine / Q000008:administration & dosage* / Q000627:therapeutic use; D000638:Amiodarone / Q000627:therapeutic use; D002405:Catheterization, Central Venous; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004630:Emergencies; D006801:Humans; D007223:Infant; D017148:Infusions, Intraosseous / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D011342:Procainamide / Q000627:therapeutic use; D011433:Propranolol; D012008:Recurrence; D013015:Sotalol / Q000627:therapeutic use; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000628:therapy; D017211:Treatment Failure; D055536:Vagus Nerve Stimulation
D011433:Propranolol; D013015:Sotalol; D000241:Adenosine; D011342:Procainamide; D000638:Amiodarone