Incidence of Bradycardia and the Use of Atropine in Pediatric Rapid Sequence Intubation in the Emergency Department.
Journal
Pediatric emergency care
ISSN: 1535-1815
Titre abrégé: Pediatr Emerg Care
Pays: United States
ID NLM: 8507560
Informations de publication
Date de publication:
01 Feb 2022
01 Feb 2022
Historique:
pubmed:
20
5
2021
medline:
3
2
2022
entrez:
19
5
2021
Statut:
ppublish
Résumé
Bradycardia during rapid sequence intubation (RSI) is an uncommon but serious adverse effect encountered in pediatric intubations. Atropine has historically been used in the pediatric population as RSI premedication to prevent bradycardia, especially when using succinylcholine as an induction agent. The objective of this analysis was to identify the incidence of bradycardia with or without atropine use. This single-center, retrospective, observational case series reviewed pediatric patients up to 18 years old requiring intubation from January 1, 2015, to December 31, 2018. Bradycardia was determined by analyzing heart rates associated with time during and up to 5 minutes after intubation. A total of 62 patients were included. Three (4.8%) patients experienced a bradycardic event during intubation. A total of 15 (24.2%) patients received atropine for pretreatment of RSI. Incidence of bradycardia was similar between those who received atropine and those who did not. An increasing trend in atropine use was shown throughout the assessment period, yet only 18 (29%) patients met criteria for atropine pretreatment based on the 2015 Pediatric Advanced Life Support guideline recommendations for RSI. Bradycardia incidence was low in pediatric patients undergoing RSI in our emergency department. Use of atropine or succinylcholine did not affect the incidence of bradycardia during pediatric intubation over this study period. Our results show a low incidence of bradycardia and support the 2015 Pediatric Advanced Life Support Guideline recommendation of limiting the use of atropine premedication in pediatric intubations.
Identifiants
pubmed: 34009889
doi: 10.1097/PEC.0000000000002382
pii: 00006565-202202000-00034
doi:
Substances chimiques
Atropine
7C0697DR9I
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e540-e543Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Disclosure: The authors declare no conflict of interest.
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