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Cardiac Monitoring and Demand Pacemaker in Guillain-Barré Syndrome

Cardiac Monitoring and Demand Pacemaker in Guillain-Barré Syndrome Abstract To the Editor.— Emmons et al (Arch Neurol 32:59, 1975) reported the use of a temporary transvenous demand pacemaker to prevent cardiac arrest from severe arrhythmias that developed during tracheal suctioning in an 11-year-old child with Guillain-Barré syndrome receiving continuous mechanical ventilation. Each episode of suctioning was associated with sinus bradycardia (day 6) or idioventricular bradycardia (days 7-12), as well as profuse diaphoresis, restlessness, and an ashen-gray color. Following suctioning, the cardiac rhythm reverted to a sinus tachycardia with systemic hypertension. The authors attributed these arrhythmias to the autonomic dysfunction that may occur with the Guillain-Barré syndrome.Previous work in the management of patients receiving continuous mechanical ventilation suggests a different cause and treatment for the observed arrhythmias. With the widespread use of mechanical ventilation to manage respiratory failure, reports of cardiac arrest during and immediately following endotracheal suctioning are not infrequent.1,2 Cardiac arrest during prolonged aspiration of the References 1. Bendixen HH, Egbert LD, Hedley-Whyte J, et al: The airway , in Respiratory Care . Saint Louis, CV Mosby Co, 1965. 2. Marx GF, Steen SN, Arkins RE, et al: Endotracheal suction and death . N York J Med 68:565-571, 1968. 3. Fell T, Cheney FW: Prevention of hypoxia during endotracheal suction . Ann Surg 174:24-28, 1971.Crossref 4. Shim C, Fine N, Fernandez R, et al: Cardiac arrhythmias resulting from tracheal suctioning . Ann Intern Med 71:1149-1153, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Cardiac Monitoring and Demand Pacemaker in Guillain-Barré Syndrome

Archives of Neurology , Volume 33 (5) – May 1, 1976

Cardiac Monitoring and Demand Pacemaker in Guillain-Barré Syndrome

Abstract

Abstract To the Editor.— Emmons et al (Arch Neurol 32:59, 1975) reported the use of a temporary transvenous demand pacemaker to prevent cardiac arrest from severe arrhythmias that developed during tracheal suctioning in an 11-year-old child with Guillain-Barré syndrome receiving continuous mechanical ventilation. Each episode of suctioning was associated with sinus bradycardia (day 6) or idioventricular bradycardia (days 7-12), as well as profuse diaphoresis, restlessness, and an...
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Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1976.00500050060017
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Emmons et al (Arch Neurol 32:59, 1975) reported the use of a temporary transvenous demand pacemaker to prevent cardiac arrest from severe arrhythmias that developed during tracheal suctioning in an 11-year-old child with Guillain-Barré syndrome receiving continuous mechanical ventilation. Each episode of suctioning was associated with sinus bradycardia (day 6) or idioventricular bradycardia (days 7-12), as well as profuse diaphoresis, restlessness, and an ashen-gray color. Following suctioning, the cardiac rhythm reverted to a sinus tachycardia with systemic hypertension. The authors attributed these arrhythmias to the autonomic dysfunction that may occur with the Guillain-Barré syndrome.Previous work in the management of patients receiving continuous mechanical ventilation suggests a different cause and treatment for the observed arrhythmias. With the widespread use of mechanical ventilation to manage respiratory failure, reports of cardiac arrest during and immediately following endotracheal suctioning are not infrequent.1,2 Cardiac arrest during prolonged aspiration of the References 1. Bendixen HH, Egbert LD, Hedley-Whyte J, et al: The airway , in Respiratory Care . Saint Louis, CV Mosby Co, 1965. 2. Marx GF, Steen SN, Arkins RE, et al: Endotracheal suction and death . N York J Med 68:565-571, 1968. 3. Fell T, Cheney FW: Prevention of hypoxia during endotracheal suction . Ann Surg 174:24-28, 1971.Crossref 4. Shim C, Fine N, Fernandez R, et al: Cardiac arrhythmias resulting from tracheal suctioning . Ann Intern Med 71:1149-1153, 1969.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: May 1, 1976

References