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Correlation Analysis between Nebulized-Salbutamol Dose and Heart Rate in Critically Ill Pediatric Patients
J. Kor. Soc. Health-syst. Pharm. 2019;36:455-461
Published online November 30, 2019;  https://doi.org/10.32429/jkshp.2019.36.4.003
© 2019 Korean Society of Health-System Pharmacists

Eun Bi Koa, Soo Jung Kima, Hye Jung Baea†, Yun Hee Joa, Yoon Sook Choa, Yu Hyeon Choib and June Dong Parkb

Department of Pharmacy, Seoul National University Hospitala
Department of Pediatrics, Seoul National University Children’s Hospitalb
101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Koreaa,b
Correspondence to: 배혜정 Tel:02-2072-3420 E-mail:baehj021004@hanmail.net
Received February 1, 2019; Revised March 7, 2019; Accepted September 20, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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 (≥0.2 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.
Keywords : Salbutamol, Pediatric intensive care units, Tachycardia


November 2019, 36 (4)