PMID: 1898143Sep 1, 1991Paper

Bezold-Jarisch reflex in postoperative pediatric cardiac surgical patients

The Annals of Thoracic Surgery
D A FullertonW M See

Abstract

The Bezold-Jarisch reflex is an inhibitory reflex that originates from the heart, is mediated by the vagus nerve, and is manifested by hypotension and bradycardia. We present 4 pediatric cardiac surgical patients, aged 1 day to 9 months, who exhibited cardiovascular collapse in their early postoperative course. In each patient, cardiovascular deterioration was marked by an insidious decrease in arterial blood pressure without an associated change in heart rate, central venous pressure, or airway pressure. Bradycardia followed the decrease in blood pressure. The Bezold-Jarisch reflex was suspected and atropine was administered, first as a bolus injection at 0.01 mg/kg, and later, as a continuous infusion at 0.01 mg.kg-1.h-1. Atropine prevented recurrent episodes of hypotension and bradycardia. We believe the Bezold-Jarisch reflex is more prevalent than previously suspected in postoperative pediatric cardiac surgical patients.

References

Sep 1, 1977·British Heart Journal·F Perez-Gomez, A Garcia-Aguado
Jul 8, 1972·British Medical Journal·S W WebbJ F Pantridge
Dec 1, 1974·The Journal of Clinical Investigation·D L EckbergF M Abboud
Oct 1, 1981·Circulation Research·I H Zucker, K G Cornish

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Citations

Aug 1, 1993·Journal of the American College of Cardiology·M J Strieper, R M Campbell
Dec 18, 2001·Journal of Applied Physiology·Luke A HendersonRonald M Harper

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