Sedation of hypercyanotic spells in a neonate with tetralogy of Fallot using dexmedetomidine.

Abstract:

OBJECTIVE:Sedation is an important step in the management of patients with hypercyanotic spells associated with tetralogy of Fallot (TOF) to ameliorate and prevent recurrence of cyanosis. This case report illustrates the effectiveness of dexmedetomidine-induced sedation in the management of hypercyanotic spells in a neonate with TOF. DESCRIPTION:An 8-day-old term newborn patient with TOF showed hypercyanotic spells, as indicated by an abrupt decrease in arterial saturation (SpO2) level measured by a pulse oximeter from 80% to as low as 50%, when the patient became irritable and agitated. We started continuous infusion of dexmedetomidine at a dose of 0.2 microg/kg/min without a loading bolus injection. About half an hour after commencement of dexmedetomidine infusion, the patient reached an acceptable level of sedation, together with a drop in heart rate by approximately 20 beats/min. There was no apparent respiratory depression or marked change in blood pressure. SpO2 was also stable during dexmedetomidine infusion. The patient underwent a successful Blalock-Taussig shunt operation on the next day of admission. COMMENTS:Dexmedetomidine may be useful for the management of hypercyanotic spells in pediatric patients with TOF.

journal_name

J Pediatr (Rio J)

journal_title

Jornal de pediatria

authors

Senzaki H,Ishido H,Iwamoto Y,Taketazu M,Kobayashi T,Katogi T,Kyo S

doi

10.2223/JPED.1794

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

377-80

issue

4

eissn

0021-7557

issn

1678-4782

journal_volume

84

pub_type

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