KMID : 0869620190360040455
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Journal of Korean Society of Hospital Pharmacists 2019 Volume.36 No. 4 p.455 ~ p.461
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Correlation Analysis between Nebulized-Salbutamol Dose and Heart Rate in Critically Ill Pediatric Patients
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Ko Eun-Bi
Kim Soo-Jung Bae Hye-Jung Jo Yun-Hee Cho Yoon-Sook Choi-Yu-Hyun Park June-Dong
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Abstract
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Background : Nebulized-salbutamol is often used for patients hospitalized in the pediatric intensive care unit (PICU) in need of respiratory support. However, there is a lack of references to establish a guideline for dosage adjustment according to each age group. Thus, the purpose of this study was to analyze the correlation between the dose of nebulized-salbutamol and heart rate (HR) in critically ill pediatric patients.
Methods : This study included critically ill pediatric patients younger than age 18, who stayed in the PICU at Seoul National University Children¡¯s Hospital July 1, 2015 July 31, 2018. The correlation between the change of HR and the dose of nebulized-salbutamol was analyzed. After that, there was an effort to identify further risk factors which can contribute to increasing HR during PICU hospitalization.
Results : There was a total of 340 cases of 87 patients who were administered nebulized-salbutamol within the first 24 hours of PICU hospitalization. There was no statistical difference in HR changes between the high dosage group (¡Ã0.2 mg/kg/dose) and the low dosage group ( 0.2 mg/kg/dose) for the first 24 hours of administration (p=0.058). The subgroup analysis was conducted using 268 cases excluding 72 cases where body temperature change was observed. There was significant increase of HR in the high dosage group (p=0.017). Twenty-five of 87 patients showed a more rapid HR after the administration of nebulized-salbutamol during PICU hospitalization. Among patients younger than age 36 months, there was a statistically significant correlation between HR rise (OR=8.739; 95% CI, 2.146-35.590; p=0.002) and the high dosage of nebulized-salbutamol (OR=4.204; 95% CI, 1.384-12.776; p=0.011).
Conclusions : The use of high dosage nebulized-salbutamol in critically ill pediatric patients may have the potential to increase HR. Thus, close monitoring is recommended when it is administered to young patients with high dosage.
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KEYWORD
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Salbutamol, Pediatric intensive care units, Tachycardia
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