Key result
Rare POLG gene mutation linked to sudden intraoperative cardiac arrest during anesthesia induction.
Why the study?
Perioperative cardiac arrest in infants and children can have devastating consequences and may rarely occur suddenly without an obvious pre-existing etiology in an otherwise apparently healthy patient.
Case Report (n=1)
No
Sudden intraoperative cardiac arrest in an otherwise healthy child may be the first presentation of an underlying genetic or metabolic condition, such as a POLG gene mutation, highlighting the need for thorough post-resuscitation diagnostic evaluation.
Answers are grounded in this paper and cite their sources.
Unexplained pediatric intraoperative arrest warrants post-event genetic evaluation; leaves open whether POLG mutations justify preoperative screening.
Although perioperative cardiac arrest during anesthetic care in infants and children is a rare event, its consequences can be devastating. Risk factors associated with perioperative cardiac arrest include cardiac surgery, younger age, presence of comorbid conditions and emergency surgery. Although medication-related etiologies formerly predominated, the elimination of halothane from anesthetic care has resulted in a shift in etiology to hemodynamic events related to blood loss or hyperkalemia associated with the rapid administration of blood products. Rarely, cardiac arrest can be sudden and unexpected without an obvious pre-existing etiology in an otherwise apparently healthy patient. We present a 16-month-old child who experienced a sudden cardiac arrest following anesthetic induction for a routine urologic procedure. The potential etiology of cardiac arrest during anesthesia is reviewed, keys to resuscitation discussed, and an outline for the investigative work-up presented.
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Fister et al. (2020) conducted a case report in Intraoperative cardiac arrest (n=1). Anesthesia induction (sevoflurane and propofol) was evaluated on Intraoperative cardiac arrest. A previously healthy 16-month-old boy experienced sudden intraoperative cardiac arrest during anesthesia induction and was subsequently diagnosed with a rare POLG gene mutation.
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