Abstract

CACERES, Rocío; PAREDES, Fátima  and  PAVLICICH, Viviana. Sudden Cardiac Arrest in a Healthy Child: A Case Report. Pediatr. (Asunción) [online]. 2013, vol.40, n.2, pp.155-160. ISSN 1683-9803.

Introduction: Aspiration of a foreign body (FB) significant preventable cause of morbidity and mortality in childhood. The repercussions of a foreign body implanted in the airway will depend on its nature, location and the degree of obstruction caused. The resulting asphyxia can cause death or hypoxic encephalopathy. Case Report: A child aged 14 months presented at the emergency department in cardiac arrest. The child had been healthy, and had been playing with small objects, pebbles, according to the grandmother, minutes before the episode. At admission he was cyanotic, with no vital signs, pulse not palpable, limbs cold, with slow capillary refill and absence of heart sounds. Advanced cardiac life support maneuvers were performed for 15 minutes, after which the patient recovered vital signs. Following hemodynamic stabilization, chest x-ray and CT scan of the skull, neck, and chest, were done, locating a foreign body (nail or screw) in the hypopharynx. The initial cranial CT suggested cerebral edema, and he was treated for acute cerebral damage with mannitol and hypertonic fluids. Repeated seizure episodes occurred and were treated with phenytoin. During his first days in the NICU, he experienced hemodynamic instability and disturbances of the fluid and electrolyte balance and required 13 days of mechanically assisted ventilation. A post-extubation CT found a diffuse cortical/subcortical hypodensity with bilateral effacement of the parietal sulci, being more notable on the left, and suggesting a non-progressing hypoxic ischemic encephalopathy. Discussion: Aspiration of a foreign body is one of the primary causes of accidental death in childhood and is most common in children under age 2 years. Knowledge concerning prevention of such accidents and of basic CPR by the family would have changed the prognosis for this patient.

Keywords : Foreign body aspiration; cardiopulmonary resuscitation; Emergency Department.

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