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Systemic atropine administration during cardiac arrest does not cause fixed and dilated pupils
1Department of Pediatrics, Henry Ford Hospital, Detroit, Michigan 48202.
Annals of Emergency Medicine
|January 1, 1991
Summary
Atropine, when given during resuscitation, causes slight pupil dilation but does not affect pupillary light reactivity. This finding is crucial for accurate neurological assessments in pediatric patients during cardiopulmonary resuscitation (CPR).
Area of Science:
- Pediatric Critical Care Medicine
- Neurology
- Pharmacology
Background:
- Systemic atropine administration during cardiopulmonary resuscitation (CPR) is suspected to interfere with neurological assessments.
- Specifically, atropine's potential to cause fixed and dilated pupils could complicate brain death determination.
Purpose of the Study:
- To investigate the effect of conventional doses of atropine on pupillary response.
- To determine if atropine, used as an adjunct to endotracheal intubation and during cardiac arrest, interferes with neurological assessment in children.
Main Methods:
- Two groups of pediatric patients were studied.
- Group 1 (n=28) received atropine (0.03 mg/kg) before endotracheal intubation.
- Group 2 (n=21) received atropine (0.03 mg/kg) after a witnessed arrest with return of spontaneous circulation.
Main Results:
- In Group 1, atropine administration resulted in a statistically significant increase in pupillary size (P < .001).
- In Group 2, pupillary diameter was measured 30 minutes post-resuscitation.
- All pupils in both groups remained reactive to light.
Conclusions:
- Conventional doses of atropine cause minor pupillary dilation.
- Atropine does not abolish pupillary light reactivity, suggesting it does not significantly hinder neurological assessment during CPR.