Successful Postnatal Cardiopulmonary Resuscitation Due to Defibrillation

Abstract

An asphyxiated term neonate required postnatal resuscitation. After six minutes of cardio-pulmonary resuscitation (CPR) and two doses of epinephrine, spontaneous circulation returned, but was shortly followed by ventricular fibrillation. CPR and administration of magnesium, calcium gluconate, and sodium bicarbonate did not improve the neonate’s condition. A counter shock of five Joule was delivered and the cardiac rhythm immediately converted to sinus rhythm. The neonate was transferred to the neonatal intensive care unit and received post-resuscitation care. Due to prolonged QTc and subsequently suspected long-QT syndrome propranolol treatment was initiated. The neonate was discharged home on day 14 without neurological sequelae.

Cardiac Arrhythmias Requiring Electric Countershock during the Neonatal Period—A Systematic Review

“…Thirty-four articles (87.2%) [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ] stated the patients’ gestational ages. The described neonates ranged from 25 +2 to 40 +4 weeks of gestation.…”

“…In 22 articles (56.4%) [ 7 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ] including 39 neonates (34.5%), rhythm disturbances were diagnosed immediately or within the first hours after birth. In 6 articles (15.4%) [ 8 , 34 , 35 , 36 , 37 , 38 ] the 62 described neonates (54.9%) were classified into an age group between birth and four weeks post-partum.…”

Stabilization and Resuscitation of Newborns

“…The case presentation by Mileder et al [ 11 ] is the first reported case of a newborn with perinatal asphyxia, who required postnatal resuscitation and defibrillation due to ventricular fibrillation following epinephrine administration. Based on this case, the authors suggest that health care providers managing neonatal resuscitation should be aware of the possible need for defibrillation, even though it may be very rare.…”

QTc Intervals Are Prolonged in Late Preterm and Term Neonates during Therapeutic Hypothermia but Normalize Afterwards

“…Besides its relevance for medication safety, there is also diagnostic relevance. In a recent case report in this journal, the postnatal management of a newborn with a congenital long QT syndrome was described [ 11 ]. The newborn had ventricular fibrillation at birth, and subsequently underwent therapeutic hypothermia [ 11 ].…”

“…In a recent case report in this journal, the postnatal management of a newborn with a congenital long QT syndrome was described [ 11 ]. The newborn had ventricular fibrillation at birth, and subsequently underwent therapeutic hypothermia [ 11 ]. In such a scenario, one needs to compare QTc intervals collected during therapeutic hypothermia to relevant reference values.…”