Department of Anesthesiology & Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Anesth Analg. 2012 Feb;114(2):407-9. doi: 10.1213/ANE.0b013e31823ed423. Epub 2012 Jan 4.
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.
长 QT 综合征的特征是心电图出现长 QT 间期和易发生多形性室性心动过速。为了获得良好的结果，特别是对于有症状的新生儿，需要积极的预期临床管理。我们介绍了一例复合突变的新生儿，其患有难治性室性心动过速，需要使用利多卡因、艾司洛尔和胺碘酮联合心室起搏进行多模式药物治疗。尽管血清利多卡因水平正常，但复杂的药代动力学相互作用导致了利多卡因的推定神经毒性。本报告讨论了管理患有复合长突变的新生儿的影响和挑战。
