Supraventricular Tachycardia Treatment in the Pediatric Emergency Department: Evaluation of Adenosine Dose and Treatment Response

• Published in: Çocuk acil ve yoğun bakım Vol. 7; no. 1; pp. 13 - 18
• Main Authors: Bıcılıoğlu, Yüksel, Anıl, Murat, Gökalp, Gamze, Ataş Berksoy, Emel, İnce, Gülberat, Bakiler, Ali Rahmi
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi 01-04-2020
• Subjects: adenosine; pediatric emergency department; supraventricular tachycardia
• ISSN: 2146-2399; 2148-7332; 2148-7332
• DOI: 10.4274/cayd.galenos.2019.27247

Introduction:Supraventricular tachycardia is the most common cause of arrhythmia in children. The aim of this study was to determine the dose and efficacy of adenosine treatment in the management of supraventricular tachycardia and to determine the factors affecting response to treatment.Methods:Patients diagnosed with supraventricular tachycardia between January 2010 and December 2015 were evaluated retrospectively. Medical history of the patients, vital signs, physical findings, treatment, number of adenosine administration and treatment responses were recorded. The patients were divided into two groups: those responding to the first dose of adenosine treatment and those not responding. These two groups were compared in terms of demographic and clinical features.Results:A total of 30 patients (17 male, 13 female) aged 2-180 months were evaluated. Vagal maneuvers were performed as initial treatment in 13 patients. Five patients (38%) responded to vagal maneuver. Twenty-four patients (80%) received adenosine treatment and 23 (95.8%) responded to treatment. Of the 23 patients, who responded to adenosine treatment, 14 (60.8%) responded to the first dose, six (26%) to the second dose, and 3 patients (13%) to the third dose. The total adenosine dose in the responders was 0.15 mg/kg (minimum: 0.1, maximum: 0.5). No side effects associated with adenosine treatment were observed. The age of responders to the first dose of adenosine was found to be greater than others (102 months vs. 5 months) (p<0.05).Conclusion:Adenosine is an effective and safe drug in the treatment of supraventricular tachycardia. However, response to the initial dose of 0.1 mg/kg adenosine is significantly lower in children younger than one year. We think that the first adenosine dose should be increased. However, further large-scale randomized controlled trials are warranted.