[婴儿中的万古霉素与心脏骤停]
[Vancomycin and cardiac arrest in the infant].
作者信息
Trentesaux A S, Bednarek N, Morville P
机构信息
Unité de réanimation infantile polyvalente, American Memorial Hospital, CHU, Reims, France.
出版信息
Arch Pediatr. 1998 May;5(5):521-4. doi: 10.1016/s0929-693x(99)80318-2.
BACKGROUND
Different adverse effects induced by vancomycin bolus infusion are described, but cardiac arrest seems rare, in children as in adults.
CASE REPORT
Two infants, 5 and 12 months old, were admitted after cardiac arrest, following vancomycin bolus infusion in excessive dose. They recovered after prompt resuscitation and their short term follow-up was normal.
CONCLUSION
Two mechanisms are invoked: anaphylactic shock and direct cardiovascular toxicity. Both are dose- and infusion rate-dependent, and probably intersubject dependent. Usually, cardiac arrest is promptly reversed by adequate resuscitation. The rules of prescription are: adequate dilution and slow rate of infusion. If any adverse effect occurred, preventive antihistaminic drug therapy should be advised.
背景
已描述了万古霉素大剂量推注引起的不同不良反应，但心脏骤停似乎在儿童和成人中都很罕见。
病例报告
两名分别为5个月和12个月大的婴儿在过量万古霉素大剂量推注后发生心脏骤停入院。经及时复苏后康复，短期随访正常。
结论
提出了两种机制：过敏性休克和直接心血管毒性。两者均与剂量和输注速率有关，可能还与个体间差异有关。通常，通过充分复苏可迅速逆转心脏骤停。处方规则为：充分稀释并缓慢输注。如果发生任何不良反应，建议进行预防性抗组胺药物治疗。
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