Abstract：
Collyrium administration is a common procedure in the neonatal ward, both in preterm and at term babies. Various molecules are used to induce mydriasis and cycloplegia: among them, phenylephrine and tropicamide are the most popular, and their administration is generally considered safe.
A 35 + 2 weeks-old, 2510 g, well-appearing male newborn required an ophthalmologic evaluation after a doubtful red reflex test. A collyrium with 1% phenylephrine and 0.95% tropicamide was administered prior to the consult, one drop per eye. Two minutes after the administration, the baby developed a severe apnea that required tactile stimulation. Moreover, the area around his eyes became visibly pale. Three minutes later, the baby became severely bradycardic (59 bpm), but remained in good general condition, so that resuscitation maneuvers were not required. Bradycardia lasted for almost three hours and then gradually resolved.
Cardiopulmonary manifestations, such as bradycardia and even cardiopulmonary arrest, are severe complications that can happen after phenylephrine collyrium administration in preterm newborns. However, they have been described in babies below 1500 g or with concurrent respiratory manifestations. Our patient, on the other hand, was late preterm, and never required a ventilatory support prior to the collyrium administration. Practitioners who deal with premature babies, even if late preterm, must be aware of these possible complications and administer phenylephrine collyrium carefully, where cardiopulmonary resuscitation equipment and personnel are available.
A 35 + 2 weeks-old, 2510 g, well-appearing male newborn required an ophthalmologic evaluation after a doubtful red reflex test. A collyrium with 1% phenylephrine and 0.95% tropicamide was administered prior to the consult, one drop per eye. Two minutes after the administration, the baby developed a severe apnea that required tactile stimulation. Moreover, the area around his eyes became visibly pale. Three minutes later, the baby became severely bradycardic (59 bpm), but remained in good general condition, so that resuscitation maneuvers were not required. Bradycardia lasted for almost three hours and then gradually resolved.
Cardiopulmonary manifestations, such as bradycardia and even cardiopulmonary arrest, are severe complications that can happen after phenylephrine collyrium administration in preterm newborns. However, they have been described in babies below 1500 g or with concurrent respiratory manifestations. Our patient, on the other hand, was late preterm, and never required a ventilatory support prior to the collyrium administration. Practitioners who deal with premature babies, even if late preterm, must be aware of these possible complications and administer phenylephrine collyrium carefully, where cardiopulmonary resuscitation equipment and personnel are available.
摘要：
Collyrium给药是新生儿病房的常见程序，早产和足月婴儿。各种分子被用来诱导散瞳和睫状肌麻痹：其中，去氧肾上腺素和托吡卡胺是最受欢迎的，他们的管理通常被认为是安全的。
35+2周龄,2510g,外观良好的男性新生儿在进行可疑的红色反射测试后需要进行眼科评估。在咨询前给予含1%去氧肾上腺素和0.95%托吡卡胺的铬，每只眼睛一滴。给药后两分钟，婴儿出现了严重的呼吸暂停，需要触觉刺激。此外，他眼睛周围的区域变得明显苍白。三分钟后,婴儿严重心动过缓（59bpm），但总体状况良好，所以不需要复苏。心动过缓持续了将近三个小时，然后逐渐解决。
心肺表现，比如心动过缓甚至心肺骤停,是早产新生儿服用去氧肾上腺素后可能发生的严重并发症。然而,他们已经被描述在婴儿低于1500克或并发呼吸表现。我们的病人,另一方面,是晚期早产,并且在服用胶前从未需要通气支持。与早产儿打交道的从业者，即使晚期早产,必须意识到这些可能的并发症，并小心地施用去氧肾上腺素，有心肺复苏设备和人员的地方。
35+2周龄,2510g,外观良好的男性新生儿在进行可疑的红色反射测试后需要进行眼科评估。在咨询前给予含1%去氧肾上腺素和0.95%托吡卡胺的铬，每只眼睛一滴。给药后两分钟，婴儿出现了严重的呼吸暂停，需要触觉刺激。此外，他眼睛周围的区域变得明显苍白。三分钟后,婴儿严重心动过缓（59bpm），但总体状况良好，所以不需要复苏。心动过缓持续了将近三个小时，然后逐渐解决。
心肺表现，比如心动过缓甚至心肺骤停,是早产新生儿服用去氧肾上腺素后可能发生的严重并发症。然而,他们已经被描述在婴儿低于1500克或并发呼吸表现。我们的病人,另一方面,是晚期早产,并且在服用胶前从未需要通气支持。与早产儿打交道的从业者，即使晚期早产,必须意识到这些可能的并发症，并小心地施用去氧肾上腺素，有心肺复苏设备和人员的地方。
