Intravenous amiodarone can cause life-threatening cardiovascular collapse in hemodynamically compromised infants with refractory SVT, acidosis, and ventricular dysfunction.
Alerts to hemodynamic collapse risk with IV amiodarone boluses in unstable infants; case report leaves optimal dosing protocols open.
We describe a 7-week-old female infant who presented with refractory supraventricular tachycardia (SVT). During amiodarone infusion, she developed hypotension and cardiac arrest requiring extracorporeal membrane oxygenation (ECMO) support. After successful control of SVT using procainamide infusion, she was weaned from ECMO and discharged home on oral flecainide. We conclude that infants with acidosis, ventricular dysfunction, and prolonged refractory SVT may poorly tolerate intravenous amiodarone.
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Saharan et al. (2015) studied this question.
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