title: Treatment of tetralogy of Fallot hypoxic spell with intranasal fentanyl.
abstract: We present the case of a 3-month-old girl who had unrepaired Tetralogy of Fallot who presented to the emergency department with an acute hypoxic episode. The patient was hyperpneic and cyanotic, with an initial oxygen saturation of 56%. She did not respond to knee-to-chest positioning. A single dose of intranasal fentanyl was administered with subsequent resolution of her symptoms and improvement of her oxygen saturation to 78% within 10 minutes. To our knowledge, this is the first report of the successful treatment of a hypoxic episode of Tetralogy of Fallot using intranasal fentanyl.
authors.affiliation: Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York dst2141@columbia.edu.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Tsze
authors.affiliation: Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Yaffa M
authors.initials: YM
authors.lastname: Vitberg
authors.affiliation: Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Joel
authors.initials: J
authors.lastname: Berezow
authors.affiliation: Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Starc
authors.affiliation: Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Dayan
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D000860:Hypoxia / Q000188:drug therapy* / Q000209:etiology*; D007223:Infant; D013771:Tetralogy of Fallot / Q000150:complications*
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: Tetralogy of Fallot; congenital heart disease; fentanyl; hypercyanotic spell; hypoxic spell; intranasal; tet spell