# Finding the contribution of the autonomic nervous system during perioperative events in children with Down Syndrome

> **NIH NIH R21** · CINCINNATI CHILDRENS HOSP MED CTR · 2021 · $421,134

## Abstract

PROJECT SUMMARY/ABSTRACT
Children with Down syndrome (DS) often experience dangerously low heart rates on induction of anesthesia
for routine procedures and this occurs at 10 times the rate of non-DS patients. Given that the cardiac output of
children is heart rate dependent, bradycardia is especially perilous in this population.
Historically, individuals with DS were not expected to survive beyond childhood; consequently, correction of
congenital anomalies, e.g. cardiac defects, was not frequently offered. Fortunately, today individuals with DS
live into adulthood and surgical correction of anomalies is universally offered. Thus, increasing numbers of
children with DS are exposed to anesthesia and at risk for this hemodynamic catastrophe. It is medically
unacceptable and requires more study.
This project seeks to address the problem of induction bradycardia by studying its mechanism. We plan to
quantify nervous system determinants of heart rate during these bradycardic events and eventually develop
protocols to identify and mitigate the risk. Specifically, we aim to:
1) Quantify the autonomic nervous system behavior during induction using multi-parameter monitoring to
potentially unveil their root cause.
2) Test the feasibility of that autonomic nervous system monitor using both ambulatory and perioperative
monitoring protocols to detect which patients are at risk.
Successful completion of this project will provide the physiologic information required to reduce the risk of
morbid bradycardic events on induction of anesthesia in children with DS.

## Key facts

- **NIH application ID:** 10295867
- **Project number:** 1R21HL162572-01
- **Recipient organization:** CINCINNATI CHILDRENS HOSP MED CTR
- **Principal Investigator:** Jamie W Sinton
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $421,134
- **Award type:** 1
- **Project period:** 2021-09-17 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295867

## Citation

> US National Institutes of Health, RePORTER application 10295867, Finding the contribution of the autonomic nervous system during perioperative events in children with Down Syndrome (1R21HL162572-01). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10295867. Licensed CC0.

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