QTc interval prolongation and severe apneas associated with a change in infant positioning.

Abstract:

:For more than a decade there has been considerable interest in the role of QT interval prolongation in the pathogenesis of sudden infant death syndrome. It has been proposed that the QT interval is a surrogate marker for autonomic instability and can be used to identify infants at risk for significant morbidity and mortality, including sudden infant death syndrome. We present the case of an infant that experienced a significant increase in his QTc, as detected by continuous QTc monitoring in the NICU after repositioning from a supine to prone position. This increase from a 413 ± 6 millisecond baseline average to 500 milliseconds was sustained for 2 hours and associated with clinically relevant apnea that ultimately required repositioning of the infant back to the supine position. Repositioning resulted in an immediate decrease of the QTc back to the previous baseline and termination of the apneic events. This case demonstrates an example of how the use of continuous QTc monitoring in the NICU setting may be used to detect QTc-accentuating factors in real time and identify situations that cause perturbations in an infant's autonomic nervous system.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Ellsworth MA,Ulrich TJ,Carey WA,Colby CE,Ackerman MJ

doi

10.1542/peds.2012-4005

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

e1690-3

issue

6

eissn

0031-4005

issn

1098-4275

pii

peds.2012-4005

journal_volume

132

pub_type

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