https://scholars.lib.ntu.edu.tw/handle/123456789/514278
標題: | Clinical manifestations and neurodevelopmental outcome following an event of accidental intramuscular injection of atracurium in newborns | 作者: | Hsieh W.-S. Huang H.-M. STEVEN SHINN-FORNG PENG Liang J.-S. Leung C. Yeh G.-C. Huang C.-C. SUH-FANG JENG |
公開日期: | 2006 | 卷: | 165 | 期: | 6 | 起(迄)頁: | 361-366 | 來源出版物: | European Journal of Pediatrics | 摘要: | Pediatric populations are at risk for medication errors that may be associated with mortality and disability. The purpose of this study was to describe the clinical manifestations of seven newborns following an event of accidental intramuscular injection of atracurium and to assess the impact on neurodevelopmental outcome. This study enrolled seven newborns who were accidentally administered 10 mg of atracurium, equivalent to 2.6-3.3 mg/ kg, in a local perinatal clinic. Accident reports and hospital records were reviewed to obtain the history and medical data for the event. The survivors were prospectively examined for their growth, health and neurodevelopment until 24 months of age. All newborns showed immediate apnea and cyanosis requiring resuscitation after atracurium injection and presented with respiratory failure and flaccid paralysis on arrival for emergency medical services. One newborn was asystolic despite resuscitation and died of multiple organ failure. Of the five survivors available for follow-up, all achieved favorable growth outcomes. However, four showed mild to significant delay in development; and two manifested mild hypomyelination of cerebral white matter on the brain magnetic resonance imaging. Conclusion: Newborns accidentally injected with high doses of atracurium are at risk of death and neurodevelopmental delay. The serious clinical manifestations, developmental delay and cerebral hypomyelination were most likely due to insufficient immediate respiratory assistance following atracurium injection. ? Springer-Verlag 2006. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/514278 | ISSN: | 0340-6199 | DOI: | 10.1007/s00431-005-0063-2 | SDG/關鍵字: | atracurium; apnea; article; assisted ventilation; asystole; child growth; child health; clinical article; cyanosis; developmental disorder; female; flaccid paralysis; human; male; medication error; multiple organ failure; myelination; nervous system development; newborn; priority journal; respiratory failure; resuscitation; Anoxia; Atracurium; Bradycardia; Brain; Cyanosis; Developmental Disabilities; Female; Follow-Up Studies; Humans; Infant, Newborn; Injections, Intramuscular; Magnetic Resonance Imaging; Male; Medical Errors; Motor Skills; Neuromuscular Nondepolarizing Agents; Nurseries, Hospital; Overdose |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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