Unilateral fixed dilated pupil in a ventilated child with asthma

An 11-year-old boy known to have asthma was referred to our intensive care unit (ICU) with progressive respiratory distress. He was sedated, paralysed, and intubated approximately 3 hours after arrival and nebulization with salbutamol and ipratropium was continued on the ventilator. About 16 hours l...

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Bibliographic Details
Published inEuropean journal of emergency medicine Vol. 7; no. 3; p. 247
Main Authors Geraerts, S D, Plötz, F B, van Goor, C, Duval, E L, van Vught, H
Format Journal Article
LanguageEnglish
Published England 01.09.2000
Subjects
Asthma - therapy
Bronchodilator Agents - adverse effects
Child
Humans
Ipratropium - adverse effects
Male
Pupil Disorders - chemically induced
Respiration, Artificial
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Summary:An 11-year-old boy known to have asthma was referred to our intensive care unit (ICU) with progressive respiratory distress. He was sedated, paralysed, and intubated approximately 3 hours after arrival and nebulization with salbutamol and ipratropium was continued on the ventilator. About 16 hours later, he presented with transient unilateral fixed dilated pupils which resolved spontaneously without any neurological deficit. Computerized tomography scan revealed no signs of generalized cerebral oedema. Local contamination with ipratropium was most likely to be the cause of pupil dilatation, which could have occurred during connecting and disconnecting the nebulization system or through contaminated hands.
ISSN:0969-9546
DOI:10.1097/00063110-200009000-00015