Document Detail

A neonate with long QT syndrome, refractory ventricular arrhythmias, and lidocaine toxicity.
MedLine Citation:
PMID:  22218697     Owner:  NLM     Status:  MEDLINE    
Long QT syndrome is characterized by electrocardiographic appearance of long QT intervals and propensity to polymorphic ventricular tachycardia. Aggressive anticipatory clinical management is required for a good outcome, especially in the symptomatic neonate. We present a neonate with a compound mutation with refractory ventricular tachycardia that necessitated multimodal pharmacotherapy with lidocaine, esmolol, and amiodarone along with ventricular pacing. Despite normal serum lidocaine levels, complex pharmacokinetic interactions resulted in presumed neurotoxicity due to lidocaine. This report discusses the implications and challenges of management of a neonate with compound long mutations.
Aruna T Nathan; Maryam Naim; Lisa M Montenegro; Victoria L Vetter
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2012-01-04
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  114     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-23     Completed Date:  2012-03-08     Revised Date:  2012-12-20    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  407-9     Citation Subset:  AIM; IM    
Department of Anesthesiology & Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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MeSH Terms
Amiodarone / administration & dosage
Anesthetics, Local / administration & dosage,  adverse effects*,  pharmacokinetics
Anti-Arrhythmia Agents / administration & dosage,  adverse effects*,  pharmacokinetics
Cardiac Pacing, Artificial
DNA Mutational Analysis
Drug Interactions
Drug Substitution
Drug Therapy, Combination
Infant, Newborn
Lidocaine / administration & dosage,  adverse effects*,  pharmacokinetics
Long QT Syndrome / diagnosis,  drug therapy*,  genetics
Propanolamines / administration & dosage
Tachycardia, Ventricular / diagnosis,  drug therapy*,  genetics
Reg. No./Substance:
0/Anesthetics, Local; 0/Anti-Arrhythmia Agents; 0/Propanolamines; 137-58-6/Lidocaine; 1951-25-3/Amiodarone; MDY902UXSR/esmolol
Comment In:
Anesth Analg. 2012 Nov;115(5):1253-4; author reply 1254   [PMID:  23093585 ]

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