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Pediatric Cardiology

, Volume 31, Issue 7, pp 1064–1069

First Online: 20 August 2010Received: 30 March 2010Accepted: 26 July 2010

Abstract

Prolongation of the QT interval is a well-documented finding in adults with severe brain injury. However, QT prolongation has not been well documented in the pediatric population with brain injury. Our objective was to determine the range of QT intervals in children with the diagnosis of brain death, hypothesizing that the QT interval corrected for heart rate QTc is longer in this population than in a normal population. All previously healthy children <18 years dying in our hospital from 1995 to 2007 with a diagnosis of brain death and at least one electrocardiogram ECG with normal anatomy by echocardiogram were included. Admission details, past medical and family history, demographic data, and laboratory data were collected. The QT and preceding RR intervals from three sinus beats on a standard 12-lead ECG were measured. The QTc was calculated with the Bazett method, and the values were averaged. Thirty-seven patients met inclusion criteria. Five had event histories concerning for possible underlying rhythm disturbances; data analysis was performed with and without these patients. The QTc data were normally distributed. The mean SD QTc for the entire cohort was 452 61 ms. Excluding the five patients, it was 449 62 ms. On multivariate analysis, sex QTc female < male and hypokalemia were associated with QTc prolongation. QTc in children with brain death is normally distributed but significantly longer than QTc in normal children. Until rapid genetic testing for channelopathies is universally available, our findings suggest that potential pediatric cardiac donors with isolated prolongation of the QTc in this setting may be acceptable in the absence of other exclusionary criteria.

KeywordsBrain death Brain injury Electrocardiographic changes Long QT  Download fulltext PDF



Author: Jennifer Plymale - Jeanny Park - JoAnne Natale - Anita Moon-Grady

Source: https://link.springer.com/



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