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The Annals of Thoracic Surgery, Vol 52, 534-536, Copyright © 1991 by The Society of Thoracic Surgeons
DA Fullerton, JA St. Cyr, DR Clarke, DN Campbell, WH Toews and WM See
The Bezold-Jarisch reflex is an inhibitory reflex that originates from the
heart, is mediated by the vagus nerve, and is manifested by hypotension and
bradycardia. We present 4 pediatric cardiac surgical patients, aged 1 day
to 9 months, who exhibited cardiovascular collapse in their early
postoperative course. In each patient, cardiovascular deterioration was
marked by an insidious decrease in arterial blood pressure without an
associated change in heart rate, central venous pressure, or airway
pressure. Bradycardia followed the decrease in blood pressure. The
Bezold-Jarisch reflex was suspected and atropine was administered, first as
a bolus injection at 0.01 mg/kg, and later, as a continuous infusion at
0.01 mg.kg-1.h-1. Atropine prevented recurrent episodes of hypotension and
bradycardia. We believe the Bezold-Jarisch reflex is more prevalent than
previously suspected in postoperative pediatric cardiac surgical patients.
ARTICLES
Bezold-Jarisch reflex in postoperative pediatric cardiac surgical patients
Department of Surgery, University of Colorado Health Sciences Center, Denver 80262.
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