Treatment of Severe Spell Syndrome in Congenitial Heart Disease

Abstract

An infant with pulmonary atresia with a ventricular septal defect, developed a severe prolonged spell associated with a possible gastrointestinal hemorrhage of unknown etiology. Arterial blood studies revealed an extremely low oxygen tension, a markedly reduced pH and slightly reduced carbon dioxide tension. Intravenous infusion of sodium bicarbonate solution was associated with dramatic improvement of the child's condition, and a return of arterial blood pH to normal levels although arterial oxygen tension had improved only slightly.