title: Retinopathy of prematurity screening leading to cardiopulmonary arrest: fatal complication of a benign procedure.
abstract: A 6-week-old female infant born at 31 weeks of gestation was brought to the ophthalmology office for retinopathy of prematurity (ROP) screening. One drop of phenylephrine (2.5%) and tropicamide (1%) ophthalmic solution was instilled in each eye for ROP evaluation. She was breast fed about 5 min after receiving the medication. She was covered in a blanket and soon her mother could not feel her suckling. Cardiopulmonary resuscitation was initiated with return of spontaneous circulation in 1-2 min. She was admitted to the paediatric intensive care unit and monitored overnight. After an uncomplicated hospital course, she was discharged the following day. It was determined that the eye drops had induced cardiopulmonary arrest (CPA) as apnoea and bradycardia of prematurity resolve by 36 weeks and CPA occurred within minutes of the medication administration. Identification of CPA, prompt intervention and awareness of the offending agent is of prime importance in management of such complications.
authors.affiliation: Western Michigan University Homer Stryker School of Medicine, Kalamazoo, Michigan, USA.
authors.forename: Yashwant
authors.initials: Y
authors.lastname: Agrawal
authors.affiliation: Western Michigan University School of Medicine, Kalamazoo, Michigan, USA.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Patri
authors.affiliation: Borgess Medical Center/Michigan State University, Kalamazoo, Michigan, USA.
authors.forename: Jagadeesh K
authors.initials: JK
authors.lastname: Kalavakunta
authors.affiliation: Borgess Medical Center/Michigan State University, Kalamazoo, Michigan, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Gupta
mesh_terms: D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D009184:Mydriatics / Q000009:adverse effects*; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D010656:Phenylephrine / Q000009:adverse effects*; D012178:Retinopathy of Prematurity / Q000175:diagnosis*; D014331:Tropicamide / Q000009:adverse effects*
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D014331:Tropicamide