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Flavin Adenine Dinucleotide-Related Adverse Event Necessitating Cardiopulmonary Resuscitation in an Infant

Shunsuke Fujii1, Kenichi Tetsuhara1, Suzu Imamura1

  • 1Department of Critical Care Medicine, Fukuoka Children's Hospital, Fukuoka, JPN.

Cureus
|March 21, 2022
PubMed

Insights

Flavin adenine dinucleotide (FAD) sodium, a form of vitamin B2, can cause severe bradycardia and hypotension in children. This case report highlights the need for slow administration and careful monitoring during FAD sodium infusion to prevent cardiopulmonary resuscitation.

Area of Science:

  • Biochemistry
  • Pediatric Cardiology
  • Mitochondrial Medicine

Background:

  • Mitochondrial rescue drugs, including vitamin B2 (flavin adenine dinucleotide, FAD), are considered for unexplained cardiac arrest or consciousness impairment potentially due to mitochondrial diseases.
  • Previous reports noted decreased blood pressure in children after intravenous FAD sodium administration.

Observation:

  • This report details the first case of a child requiring cardiopulmonary resuscitation (CPR) after receiving FAD sodium infusion.
  • The patient presented with severe bradycardia and hypotension.

Findings:

  • Intravenous FAD sodium infusion can precipitate severe hemodynamic instability, including bradycardia and hypotension, necessitating CPR in pediatric patients.
  • This adverse event underscores a critical risk associated with FAD sodium therapy.

Implications:

  • Intravenous FAD sodium should be administered with extreme caution in pediatric patients.
  • Slow infusion rates and continuous, vigilant monitoring of blood pressure and heart rate are essential during FAD sodium administration.
  • This finding may influence clinical guidelines for the use of FAD sodium in treating mitochondrial disorders or related conditions.

Keywords:
adverse eventcardiopulmonary resuscitationflavin adenine dinucleotidemitochondrial diseasevitamin b2

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