Jeong, Goun
(Department of Pediatrics, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine)
,
Shin, Son Moon
(Department of Pediatrics, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine)
,
Kim, Nam Su
(Department of Pediatrics, Hanyang University College of Medicine)
,
Ahn, Young Min
(Department of Pediatrics, Eulji General Hospital, Eulji University School of Medicine)
Purpose: This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. Methods: We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on...
Purpose: This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. Methods: We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest. Results: Fourteen patients were identified. Of these, 13 were young children (<2 years old), and 1 was 14 years old. All patients had been previously healthy and had no specific risk factors for sudden cardiorespiratory arrest. Most cases (n=11, 79%) were defined as cardiac or cardiorespiratory arrest, while the remaining cases (n=3, 21%) were defined as respiratory arrest. Aspiration (n=3), acute myocarditis (n=2), and laryngeal chemoreflex (n=1) were presumed as the causes; however, the exact causes were unclear. The overall prognosis was poor (death, n=7; morbidity, n=5; full recovery, n=2). The medical institutions faced severe backlash because of these incidents (out-of-court settlement, n=5; medical lawsuit, n=5; continuous harassment, n=3). Conclusion: Cardiorespiratory arrest after venipuncture is unpredictable and the probable cause of most cases is a vasovagal reaction. Medical personnel must be aware of the risk of unexpected cardiorespiratory arrest during routine intravenous procedures.
Purpose: This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children. Methods: We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest. Results: Fourteen patients were identified. Of these, 13 were young children (<2 years old), and 1 was 14 years old. All patients had been previously healthy and had no specific risk factors for sudden cardiorespiratory arrest. Most cases (n=11, 79%) were defined as cardiac or cardiorespiratory arrest, while the remaining cases (n=3, 21%) were defined as respiratory arrest. Aspiration (n=3), acute myocarditis (n=2), and laryngeal chemoreflex (n=1) were presumed as the causes; however, the exact causes were unclear. The overall prognosis was poor (death, n=7; morbidity, n=5; full recovery, n=2). The medical institutions faced severe backlash because of these incidents (out-of-court settlement, n=5; medical lawsuit, n=5; continuous harassment, n=3). Conclusion: Cardiorespiratory arrest after venipuncture is unpredictable and the probable cause of most cases is a vasovagal reaction. Medical personnel must be aware of the risk of unexpected cardiorespiratory arrest during routine intravenous procedures.
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문제 정의
The limitations of this study were the relatively small sample size due to the low response rate, difficulties in remembering the experience to complete the questionnaire, and the lack of precise medical evaluation in individual cases for the cause of the sudden arrest. Nonetheless, our study is the first to explore the medical and socio-environmental characteristics of unexpected sudden arrest associated with venipuncture. To our knowledge, our study is the first report of cardio-respiratory arrest following venipuncture in neonate and young infant.
제안 방법
The limitations of this study were the relatively small sample size due to the low response rate, difficulties in remembering the experience to complete the questionnaire, and the lack of precise medical evaluation in individual cases for the cause of the sudden arrest. Nonetheless, our study is the first to explore the medical and socio-environmental characteristics of unexpected sudden arrest associated with venipuncture.
While preparing for the paper, further replies were received and 3 cases were newly included. The questionnaire included patient demographics, past medical history, family history, underlying disease, socio-environmental circumstances of venipuncture (purpose, place, time to arrest after venipuncture, performer, fasting time before the procedure, vital signs monitoring, and blood loss volume), type of arrest, symptoms and signs, treatments, prognosis, and presumptive causes of arrest. The data were analyzed using Excel 2013 (Microsoft, Redmond, WA, USA).
대상 데이터
Of the collected data, we present the most well-described case in detail. A 1-month-old boy was admitted to the hospital for a fever. He was born at a gestational age of 39 weeks, with a birth weight of 2.
Fourteen cases were identified through our survey. The clinical characteristics of the patients are given in Table 1.
A 1-month-old boy was admitted to the hospital for a fever. He was born at a gestational age of 39 weeks, with a birth weight of 2.8 kg without perinatal problems. His family history was unremarkable.
The authors thank the Korean Pediatric Society, its Legislation Board, and the Korean Society of Sudden Death in Childhood for preparing the survey report and collecting data.
이론/모형
kr. The survey questionnaire was designed by the Legislation Board of Korean Pediatric Society and the Korean Society of Sudden Death in Childhood. Members of the Korean Pediatric Society were identified from the 2015 member directory.
성능/효과
In conclusion, cardio-respiratory arrest after venipuncture is unpredictable, and a vasovagal reaction may be the cause. The pathogenic mechanism of this event must be clarified in order to prevent this tragic complication in the future.
참고문헌 (29)
1 Tizes R Cardiac arrest following routine venipuncture JAMA 1976 236 1846 1847
4 Betsuyaku T Kumamoto H Yokosiki N Nomura T Yosida I Sakurai M A case of vasovagal syncope associated with venipuncture Kokyu To Junkan 1992 40 831 833 1529181
5 Lipton JD Forstater AT Recurrent asystole associated with vasovagal reaction during venipuncture J Emerg Med 1993 11 723 727 8157910
6 Cho EJ Rho TH Kim HY Kim CJ Lee MY Jin SW Recurrent asystoles associated with vasovagal reaction during venipuncture Korean J Intern Med 2000 15 232 235 11242812
8 Ruetz PP Johnson SA Callahan R Meade RC Smith JJ Fainting: a review of its mechanisms and a study in blood donors Medicine (Baltimore) 1967 46 363 384 4864338
10 France CR France JL Carlson BW Himawan LK Stephens KY Frame-Brown TA Fear of blood draws, vasovagal reactions, and retention among high school donors Transfusion 2014 54 3 Pt 2 918 924 23915025
11 Liberthson RR Sudden death from cardiac causes in children and young adults N Engl J Med 1996 334 1039 1044 8598843
12 Alapati S Strobel N Hashmi S Bricker JT Gupta-Malhotra M Sudden unexplained cardiac arrest in apparently healthy children: a single-center experience Pediatr Cardiol 2013 34 639 645 23052663
13 Chen MY Goldenberg IF Milstein S Buetikofer J Almquist A Lesser J Cardiac electrophysiologic and hemodynamic correlates of neurally mediated syncope Am J Cardiol 1989 63 66 72 2909161
14 Morillo CA Eckberg DL Ellenbogen KA Beightol LA Hoag JB Tahvanainen KU Vagal and sympathetic mechanisms in patients with orthostatic vasovagal syncope Circulation 1997 96 2509 2513 9355886
15 Shim SH Park SY Moon SN Oh JH Lee JY Kim HH Baseline heart rate variability in children and adolescents with vasovagal syncope Korean J Pediatr 2014 57 193 198 24868217
19 McIntosh HD The stabilizing and unstabilizing influences of neurogenic and vascular activities of the heart as related to sudden cardiac death J Am Coll Cardiol 1985 5 6 Suppl 105B 110B
20 Milstein S Buetikofer J Lesser J Goldenberg IF Benditt DG Gornick C Cardiac asystole: a manifestation of neurally mediated hypotension-bradycardia J Am Coll Cardiol 1989 14 1626 1632 2685076
21 Adelson L Kinney ER Sudden and unexpected death in infancy and childhood Pediatrics 1956 17 663 699 13322513
23 American Academy Section on Cardiology and Cardiac Surgery. Pediatric sudden cardiac arrest Pediatrics 2012 129 e1094 e1102 22451713
24 Eder AF Dy BA Kennedy JM Notari Iv EP Strupp A Wissel ME The American Red Cross donor hemovigilance program: complications of blood donation reported in 2006 Transfusion 2008 48 1809 1819 18631167
25 Newman BH Newman DT Ahmad R Roth AJ The effect of wholeblood donor adverse events on blood donor return rates Transfusion 2006 46 1374 1379 16934074
26 World Health Organization WHO guidelines on drawing blood: best practices in phlebotomy Geneva (Switzerland) World Health Organization 2010
27 Mantia AM Phillips OC Lidocaine skinwheal fails to prevent vasovagal reflex during venipuncture W V Med J 1987 83 273 274 3474828
28 Kinsella SM Tuckey JP Perioperative bradycardia and asystole: relationship to vasovagal syncope and the Bezold-Jarisch reflex Br J Anaesth 2001 86 859 868 11573596
29 Academy of Breastfeeding Medicine ABM Clinical Protocol #25: Recommendations for preprocedural fasting for the breastfed infant: “NPO” Guidelines Breastfeed Med 2012 7 197 120 22803929
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