Background
Prolongation of the QT interval occurs in adults with severe brain injury. However whether there is significant QT prolongation in children with brain injury is unknown. The objective of this study was to test the hypothesis that the QT interval corrected for heart rate (QTc) is longer in this population than expected for a normal population. Mechanism of brain injury, electrolytes, cardiac function, age, and gender were also evaluated.
Methods
All previously healthy children (<18 years) cared for in our hospital from 1995-2007 with brain death who had at least one 12-lead ECG and normal anatomy by echo were included. Admission details, past medical/family history, demographics, medications and laboratory data were collected. The QTc was measured by two independent observers blinded to clinical history. QTc was calculated using the Bazett method.
Results
37 patients met inclusion criteria. Five patients had event histories concerning for possible Long QT Syndrome; data analysis was performed with and without these patients. The QTc data were normally distributed. The mean(SD) QTc for the entire cohort was 452(61)ms; excluding the five patients, 449(62)ms. On multivariate analysis, gender (QTc femaleConclusions
QTc in children with brain death is normally distributed but higher than expected for normal children. This information is important for clinicians attempting to determine the cause of death and/or if the patient is being considered for organ donation.