Complete atrioventricular block during neonatal intubation: a case report

IF 2.1 Q3 CRITICAL CARE MEDICINE

Resuscitation plus Pub Date : 2025-05-08 DOI:10.1016/j.resplu.2025.100978

Justine Dauby , Caroline Jacquemart , Sophie Tribolet , Vincent Rigo

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Abstract

Preterm infants often experience side effects from intubation. Desaturation and sinus bradycardia are frequent. Atropine as premedication mitigates these risks.

We report the occurrence of severe bradycardia related to atrioventricular block during intubation. The infant experienced severe bradycardia not responsive to effective endotracheal ventilation. The electrocardiogram trace displayed an initial 2:1 Mobitz II block with a rapid progression to complete atrioventricular block.

Congenital atrioventricular block is mostly related to atrioventricular node lesions by maternal anti-SSA/anti-SSB antibodies, but, in some cases, atrioventricular block may be paroxysmal and vagally mediated.

Although most rhythm disturbances secondary to intubation are sinus bradycardias, other bradyarhythmia, such as atrioventricular block, should be considered and treated rapidly. Clues for non-sinus bradycardia include initial sharp decrease in heart rate, and a fixed low heart rate despite adequate ventilation.

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新生儿插管时完全性房室传导阻滞1例

早产儿经常经历插管的副作用。血饱和度过低和窦性心动过缓是常见的。阿托品作为预用药可减轻这些风险。我们报告插管期间发生与房室传导阻滞相关的严重心动过缓。婴儿出现严重的心动过缓，对有效的气管内通气无反应。心电图示出最初的2:1 Mobitz II型传导阻滞，并迅速发展为完全房室传导阻滞。先天性房室传导阻滞主要与母体抗ssa /抗ssb抗体引起的房室结病变有关，但在某些情况下，房室传导阻滞可能是阵发性和迷走神经介导的。虽然大多数继发于插管的心律失常是窦性心动过缓，但其他的心动过缓，如房室传导阻滞，应被考虑并迅速治疗。非窦性心动过缓的线索包括最初心率急剧下降，尽管通气充足，但心率仍固定在较低水平。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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