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Cardiotoxicity Associated with Midazolam in a Patient with Diphtheria
Jayendra R Gohil1, Sonal Jindal1
1Pediatrics Department, Government Medical College, Sir T. General Hospital, Bhavnagar, Gujarat, India.
Current Drug Safety
|November 6, 2018
Summary
Midazolam infusion for sedation in a child with myocarditis led to adverse cardiorespiratory events, including bradycardia and death. Caution is advised due to potential cardiotoxicity in pediatric patients with heart conditions.
Area of Science:
- Pediatric Critical Care Medicine
- Pharmacology
- Cardiology
Background:
- Continuous intravenous (IV) midazolam infusion is commonly used for sedation in pediatric intensive care.
- Adverse cardiorespiratory events have been associated with midazolam use.
Observation:
- A 5-year-old male child with diphtheria-induced airway obstruction and myocarditis received IV midazolam for sedation during mechanical ventilation.
- Six hours post-infusion initiation, the patient developed pulsus bigeminus and bradycardia.
Findings:
- The patient experienced a fatal cardiorespiratory event two hours after developing pulsus bigeminus and bradycardia.
- This case highlights a potential cardiotoxic effect of midazolam in a pediatric patient with pre-existing myocarditis.
Implications:
- Midazolam should be administered with extreme caution in pediatric patients diagnosed with myocarditis.
- Further research is warranted to understand the cardiotoxic potential of midazolam in pediatric cardiac conditions.
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