An oculo-cardiac hypothesis of Sudden Unexpected Death in Infants

Hayes, R.W.; McBrearty, E.

doi:10.1016/0306-9877(79)90113-0

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…32,38,39 With this pediatric predominance, the trigeminocardiac reflex has a theorized implication in sudden infant death syndrome due to increased vagal predominance. 15,34,40 Other well-defined predictors and risk factors for developing trigeminocardiac reflex include specific medial rectus muscle manipulation, direct pressure to globe or other ocular manipulation, retrobulbar blocks, active facial trauma, orbital floor fracture, strabismus surgery, detached retinal surgery, hypoxemia or hypercarbia, and concurrent use of opioids, beta-blockers, and calcium channel blockers. 6,11,17,[41][42][43][44][45][46][47]…”

Section: Risk Factors/epidemiologymentioning

confidence: 99%

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Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery

Poe

Bosley²,

Steele³

et al. 2023

Dermatol Surg

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BACKGROUNDThe trigeminocardiac reflex is a common but underreported occurrence that can vary from benign to life threatening. This reflex can be elicited by placing direct pressure on the globe of the eye or from traction of the extraocular muscles, stimulating the trigeminal nerve.OBJECTIVETo provide a review of potential stimuli for the trigeminocardiac reflex within dermatologic surgery and to discuss management options for the treatment of the trigeminocardiac reflex.METHODSPubMed and Cochrane were used to identify articles and case reports that established scenarios in which the trigeminocardiac reflex was provoked and subsequently how the reflex was managed.RESULTSWithin the field of dermatologic surgery, the trigeminocardiac reflex can be stimulated during biopsies, cryoablations, injections, laser treatments, Mohs micrographic surgery, and oculoplastic interventions, most often occurring in an office setting. The most common presentations include significant bradycardia, hypotension, gastric hypermobility, and lightheadedness. The most definitive treatment is cessation of the inciting stimulus, monitoring, and symptomatic management. Glycopyrrolate and atropine are common treatments for severe, intractable cases of the trigeminocardiac reflex.CONCLUSIONThe trigeminocardiac reflex, while underreported and underrepresented in dermatologic literature and dermatologic surgery settings, should be considered in the setting of bradycardia and hypotension during dermatologic procedures.

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Section: Risk Factors/epidemiologymentioning

confidence: 99%

“…Most publications thus far have fallen under pediatrics, neurosurgery, and anesthesia. 11–31 Importantly, despite clear links to procedures practiced daily, there has been little research within otolaryngology, dermatologic, and oculoplastic surgery. 3,5,20,22,32,33…”

mentioning

confidence: 99%

Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery

Poe

Bosley²,

Steele³

et al. 2023

Dermatol Surg

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“… 204 The oculocardiac reflex, or globe pressure has been proposed as a mechanism for sudden infant death syndrome (SIDS). 205 , 206 A TrigeminoVagal (TVR) or trigeminocardiac reflex has been described. 187 , 207–210 …”

Section: Influence Of Anesthesiologistmentioning

confidence: 99%

The Oculocardiac Reflex: A Review

Arnold¹

2021

OPTH

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Background A typical oculocardiac reflex (OCR) is a moderate trigemino-vagal bradycardia elicited by tension on an extraocular muscle (EOM) during strabismus surgery; however, many other orbital stimuli can elicit cardiac slowing including retinopathy of prematurity examination. Methods World literature related to trigeminovagal and oculocardiac reflex covering over 15,000 patients including 51 randomized clinical trials and case reports are analyzed and reviewed. Under an ongoing observational trial in Alaska, anesthetic, patient and surgical influences on routine strabismus surgery using prospective, uniform EOM tension are compared seeking sufficient sample size to characterize this individually widely variable cardiac response. Results With adequate sample size, and emphasizing clinical studies controlling type of EOM, muscle tension amount and duration, anticholinergic and opioid medications, the following augment OCR; rapid-acting opioids and dexmedetomidine while OCR is reduced in older patients, the right eye, less EOM tension, deeper inhaled agents, hypocarbia, anticholinergic medications and orbital block. In re-operations, the former are relatively poor predictors of subsequent OCR. Conclusion Profound bradycardia can occur in almost 10% of strabismus surgery cases without anticholinergic preventive measures, but reliable prediction of OCR remains elusive. With foreknowledge and careful anesthetic monitoring of the patient before EOM manipulation, residual adverse sequelae from OCR are fortunately very rare. Despite well over a century of experience, the teleology for this occasionally dramatic cardiac response to eye surgery is still not known.

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“…A relação da posição de dormir com as mortes inesperadas, na infância, vem desde a Idade Antiga, havendo referências no Primeiro Livro dos Reis, no Velho Testamento e, também, na Civilização Helênica, com a citação de Soran de Éfeso sobre a colocação elevada da cabeça dos bebês, ao dormir, cuja interpretação pode ser entendida como orientação para se colocar a criança em decúbito dorsal, segundo Norvenius (1995) (13) . No final da década de setenta (70), a hipótese do reflexo oculocardíaco, em que a compressão do olho pelas cobertas poderia levar a uma disfunção cardíaca, levantou suspeitas de que a posição de bruços, ao dormir, poderia ter relação com a morte súbita (37) . As evidências iniciais da ligação entre a posição de bruços, ao dormir, e a Síndrome da Morte Súbita na Infância foram feitas na Austrália (38,39) .…”

Section: Fatores De Riscounclassified

Síndrome da morte súbita na infância

Castro

Peres²

1998

Medicina (Ribeirão Preto)

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RESUMO:A Síndrome da Morte Súbita da Infância (SIDS) é uma entidade ainda pouco diagnosticada em nosso meio, mas que se constitui na principal causa de morte no primeiro ano de vida, nos países industrializados. Acomete crianças aparentemente hígidas, bem nutridas e cuidadas, no primeiro ano de vida, porém com nítido pico entre o terceiro (3º) e o quarto (4º) mês de vida. Nesta revisão, procuramos mostrar a evolução histórica desta síndrome, bem como analisar as principais hipóteses e fatores de risco ligados a ela, além de mostrar o panorama atual no Brasil e no mundo.

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An oculo-cardiac hypothesis of Sudden Unexpected Death in Infants

Cited by 8 publications

References 5 publications

Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery

Trigeminocardiac Reflex: A Review and Key Implications to Dermatologic Surgery

The Oculocardiac Reflex: A Review

Síndrome da morte súbita na infância

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