Korean J Pediatr.  2018 Apr;61(4):108-113. 10.3345/kjp.2018.61.4.108.

Sudden unexpected cardio-respiratory arrest after venipuncture in children

• Jeong G
• Shin SM
• Kim NS
• Ahn YM

• KMID: 2409830
• DOI: http://doi.org/10.3345/kjp.2018.61.4.108

Abstract

PURPOSE
This study aimed to investigate the clinical and socioenvironmental characteristics of sudden cardiorespiratory arrest after venipuncture in children.
METHODS
We conducted a retrospective email-based survey of all members of the Korean Pediatric Society. The questionnaire included items on patient demographics, socioenvironmental circumstances of the venipuncture, type of cardiorespiratory arrest, symptoms and signs, treatment, prognosis, and presumed cause of the arrest.
RESULTS
Fourteen patients were identified. Of these, 13 were young children (< 2 years old), and 1 was 14 years old. All patients had been previously healthy and had no specific risk factors for sudden cardiorespiratory arrest. Most cases (n=11, 79%) were defined as cardiac or cardiorespiratory arrest, while the remaining cases (n=3, 21%) were defined as respiratory arrest. Aspiration (n=3), acute myocarditis (n=2), and laryngeal chemoreflex (n=1) were presumed as the causes; however, the exact causes were unclear. The overall prognosis was poor (death, n=7; morbidity, n=5; full recovery, n=2). The medical institutions faced severe backlash because of these incidents (out-of-court settlement, n=5; medical lawsuit, n=5; continuous harassment, n=3).
CONCLUSION
Cardiorespiratory arrest after venipuncture is unpredictable and the probable cause of most cases is a vasovagal reaction. Medical personnel must be aware of the risk of unexpected cardiorespiratory arrest during routine intravenous procedures.

Keyword

Venipuncture; Heart arrest; Vasovagal reaction; Child; Cardiopulmonary resuscitation

MeSH Terms

Cardiopulmonary Resuscitation
Child*
Demography
Heart Arrest
Humans
Myocarditis
Phlebotomy*
Prognosis
Retrospective Studies
Risk Factors