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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
PubMed
Abstract

Insights

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.
Keywords:
Cardio-toxicitybradycardiadiphtheriamidazolammyocarditispulsus bigeminus.

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