Published online May 1, 2006
PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1814-1817 (doi:10.1542/10.1542/peds.2005-1992)
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EXPERIENCE AND REASON

Sudden Cardiac Arrest in an Intubated Premature Infant With Cerebellar and Brainstem Injury: Is There a Link?

R. Victoria Chen, MD and Jeffrey Perlman, MB, ChB

Department of Pediatrics, Weill Medical College of Cornell University, New York, New York

The ventilated premature infant frequently exhibits unprovoked desaturation episodes accompanied by bradycardia. In most instances, these episodes are short-lived and recover spontaneously or with minimal interventions. However, in some infants these episodes may be more profound and require substantial interventions to restore cardiorespiratory status. Here we present the case of a ventilated premature infant who had experienced prolonged, multiple daily desaturation episodes accompanied by bradycardia that required significant interventions. Postoperatively, after placement of a tracheotomy and despite a patent airway, the infant developed acute bradycardia that progressed rapidly to sudden death. At autopsy, significant cerebellar and brainstem injury was noted. We hypothesize that the specific cerebellum and brainstem injury may have contributed to autonomic dysfunction and sudden death.

Key Words: cardiopulmonary resuscitation • premature infant • cerebellar injury

Abbreviations: DOL, day of life • SIDS, sudden infant death syndrome

Accepted Oct 24, 2005.


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