title: Atrial arrhythmia after newborn eye exam, to caffeine or not to caffeine?
abstract: Mydriatic drops are routinely administered to premature neonates to screen for retinopathy of prematurity. Adverse anticholinergic side effects, particularly convulsions and tachycardia have been reported in the pediatric age group following instillation of mydriatics for diagnostic fundus examination [1, 2]. Caffeine is frequently used for apnea of prematurity. In the neonatal intensive care unit, the combined use of caffeine and mydriatic drops is a common practice. Here we report two cases of atrial arrhythmias after neonatal eye exam that improved with conservative management. Both patients were receiving caffeine at the time of events.
authors.affiliation: Department of Pediatrics, McMaster University, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Ahmad
authors.affiliation: Department of Pediatrics Cardiology, McMaster University, ON, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Mondal
authors.affiliation: Department of Development Pediatrics, McMaster University, ON, Canada.
authors.forename: B
authors.initials: B
authors.lastname: Klein
mesh_terms: D001049:Apnea / Q000188:drug therapy*; D018880:Atrial Premature Complexes / Q000139:chemically induced*; D001919:Bradycardia / Q000139:chemically induced*; D002110:Caffeine / Q000009:adverse effects*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003519:Cyclopentolate / Q000009:adverse effects; D004347:Drug Interactions; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D009184:Mydriatics / Q000009:adverse effects*; D009887:Ophthalmoscopy / Q000379:methods*; D010656:Phenylephrine / Q000009:adverse effects; D012178:Retinopathy of Prematurity / Q000175:diagnosis*
chemical_list: D000697:Central Nervous System Stimulants; D009184:Mydriatics; D010656:Phenylephrine; D002110:Caffeine; D003519:Cyclopentolate
keywords: Neonate; arrhythmia; caffeine; cyclopentolate; eye exam; mydriatrics; newborn