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Corrected QT Interval in Children With Brain Death.
Jennifer Plymale1, Jeanny Park, Joanne Natale
1Herma Heart Center, Children's Hospital of Wisconsin, Milwaukee, WI, 53226, USA. jplymale@chw.org
Pediatric Cardiology
|August 21, 2010
Summary
QT interval prolongation is common in pediatric brain death patients. This study found corrected QT intervals (QTc) are significantly longer in these children than in healthy populations, aiding donor acceptability assessments.
Area of Science:
- Pediatric Cardiology
- Neurology
- Critical Care Medicine
Background:
- QT interval prolongation is recognized in adult brain injury but less documented in children.
- Brain death in pediatric patients presents unique challenges for cardiac assessment.
Purpose of the Study:
- To determine the range of QT intervals in children diagnosed with brain death.
- To hypothesize that the corrected QT interval (QTc) is prolonged in pediatric brain death patients compared to normal populations.
Main Methods:
- Retrospective analysis of electrocardiograms (ECGs) from children (<18 years) diagnosed with brain death (1995-2007).
- Inclusion criteria: previously healthy, normal echocardiogram, at least one ECG.
- QT and RR intervals measured; corrected QT (QTc) calculated using Bazett's method.
Main Results:
- Thirty-seven pediatric patients met inclusion criteria.
- Mean QTc was 452 (61) ms, significantly longer than in normal pediatric populations.
- Multivariate analysis identified female sex and hypokalemia as associated with QTc prolongation.
Conclusions:
- QTc is normally distributed but significantly prolonged in pediatric brain death.
- Findings suggest potential pediatric cardiac donors with isolated QTc prolongation may be acceptable.
- Further research into genetic channelopathies is warranted for comprehensive donor evaluation.
