Catecholamine Toxicity After Craniotomy and Evacuation of the Abscess

Abstract

BACKGROUND: Brain abscess is a focal infection in the brain parenchyma, may be through direct extension or hematogenous. Brain abscess is a rare complication of neonatal meningitis that occurs in 1–4% of all cases. In infants and toddlers, bacterial meningitis or bacteremia is the major cause.

CASE REPORT: In this case, the patient is diagnosed with a brain abscess since birth. According of the history, physical examination, and investigations, it was concluded the diagnosis of epidural abscess with abscess evacuation craniotomy and PS ASA 2 (leukocytosis) with GA-ETT anesthesia. The operation is carried out with a duration of 4 h. Vital sign monitoring obtained blood pressure 108–125/62–90 mmHg, heart frequency 90–120 times/min, and 99% oxygen saturation. When in the recovery room, the patient experiences cardiac arrest. Sudden cardiac arrest in children is a rare event. This is thought to result from catecholamine toxicity. Patient is treated as resuscitation in accordance with the algorithm of cardiac arrest in children. Patient experienced a response of spontaneous circulation and performed vital sign monitoring.

CONCLUSION: Increasing levels of endogenous catecholamines occur acutely to provide short-time adaptation to stressful conditions. Catecholamine toxicity requires multidisciplinary management.