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首页> 外文期刊>The Indian Journal of Pediatrics >Lower arrythmogenic risk of low dose albuterol plus ipratropium
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Lower arrythmogenic risk of low dose albuterol plus ipratropium

机译：低剂量沙丁胺醇联合异丙托铵可降低心律失常的风险

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Objective : Wheezy infants are in need of urgent bronchodilatation owing to their intermittent bronchoconstriction. β2 agonists are frequently used in emergencies and have previously shown to increase the QT dispersion (QTd), which may be associate with high risk of cardiac arrhythmia, in asthmatics. However, effect of low dose β2 agonist therapy in combination with the anticholinergic agents on QTd in wheezy infants is not known. This study aimed to assess the effect of standard dose of nebulized albuterol (NAB) and low doses of NAB combined with ipratropium-bromide (NIB) on QTd in wheezy infants.Methods : Twenty-nine children, under 2 years old, with the diagnosis of wheezy infant with acute exacerbation were enrolled in the study. Thirteen were treated by standard dose of NA therapy (0.15 mg/kg) and low doses of NAB (0.075 mg/kg) plus NIB (250 ug/dose) therapy was given to the remaining subjects. Respiratory distress score, O2 saturation and side effects were studied and QTd were measured from the standard electrocardiograms at baseline and after treatment. Significant improvement was achieved in clinical score and oxygenation of both groups.Result : The evaluation of the corrected QTd (QTcd) showed that there was no significant difference between pretreatment values of both groups (p > 0.05). However, while there was no statistically significant difference in the pre and post-treatment values of QTcd of infants treated with combination therapy, QTcd was found to be significantly increased in NAB group after treatment (p < 0.05).Conclusion : Our results suggest that, while clinical improvement is same, the increase of the QT dispersion is more prominent with the use of standard dose of NAB compared to low dose NAB plus NIB therapy. So, low dose of β2 agonist in combination with anticholinergic agents may much safer than the use of standard dose of β2 agonists alone in regard to preventing the possibility of arrythmogenic effects in wheezy infants with acute exacerbation.
机译：目的：喘息性婴儿由于间歇性支气管收缩而需要紧急支气管扩张。 β2激动剂经常用于紧急情况中，先前已证明会增加QT离散度（QTd），这可能与哮喘患者发生心律不齐的高风险有关。但是，尚不知道低剂量β2激动剂疗法与抗胆碱能药联用对喘息婴儿QTd的作用。这项研究旨在评估标准剂量雾化沙丁胺醇（NAB）和低剂量NAB联合异丙托溴铵（NIB）对喘息婴儿QTd的影响。方法：29名2岁以下的儿童进行了诊断本研究纳入了1例急性发作的喘息婴儿。 13例接受标准剂量的NA治疗（0.15 mg / kg），其余受试者接受低剂量的NAB（0.075 mg / kg）加NIB（250 ug /剂量）治疗。研究了基线和治疗后的呼吸窘迫评分，O2 饱和度和副作用，并根据标准心电图测量了QTd。两组的临床评分和氧合水平均有显着改善。结果：校正后的QTd（QTcd）评估显示，两组的预处理值之间无显着差异（p> 0.05）。然而，尽管联合治疗的婴儿的治疗前后QTcd值无统计学差异，但NAB组治疗后QTcd显着增加（p <0.05）。结论：我们的结果表明，尽管临床改善相同，但与低剂量NAB加NIB治疗相比，使用标准剂量NAB可使QT离散度增加更为明显。因此，就预防急性发作性喘息婴儿的致癌性作用的可能性而言，低剂量的β2激动剂与抗胆碱能药合用可能比单独使用标准剂量的β2激动剂更安全。

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