Safety and efficacy of a drug regimen to control heart rate during 64-slice ECG-gated coronary CTA in children
| Autor: | Angela C. Nicholas, Tetsu Uejima, Deli Wang, Cynthia K. Rigsby, Christianne Leidecker, Peter Anley, R. Andrew DeFreitas, Andrew J. Johanek |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Adrenergic beta-Antagonists Cardiac-Gated Imaging Techniques Remifentanil Vasodilation Coronary Artery Disease Coronary Angiography Sensitivity and Specificity Electrocardiography Heart Rate Internal medicine Heart rate Humans Medicine Radiology Nuclear Medicine and imaging Child Drug regimen Neuroradiology business.industry Ultrasound Infant Newborn Infant Reproducibility of Results Esmolol Radiographic Image Enhancement Coronary arteries medicine.anatomical_structure Child Preschool Anesthesia Pediatrics Perinatology and Child Health Cardiology Female Tomography X-Ray Computed business medicine.drug |
| Zdroj: | Pediatric Radiology. 40:1880-1889 |
| ISSN: | 1432-1998 0301-0449 |
| DOI: | 10.1007/s00247-010-1711-x |
| Popis: | The adult practice for ECG-gated single-source 64-slice coronary CTA (CCTA) includes administering beta-blockers to reduce heart rate. There are limited data on this process in children. To evaluate the safety and efficacy of a drug regimen to decrease heart rate before performing CCTA in children. IV remifentanil and esmolol infusion were chosen to decrease heart rate in 41 children (mean age 6.5 years) while they were under general anesthesia (GA) for CCTA. Drug doses, changes in heart rate and procedural complications were recorded. CCTA image quality was graded on a scale of 1 to 5. The relationships between image quality and heart rate and image quality and age were evaluated. Patient effective radiation doses were calculated. Heart rates were lowered utilizing esmolol (4 children), remifentanil (2 children) or both (35 children); 26 children received nitroglycerin for coronary vasodilation. The mean decrease in heart rate was 26%. There were no major complications. The average image-quality score was 4.4. Higher heart rates were associated with worse image quality (r = 0.67, P |
| Databáze: | OpenAIRE |
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