Efficacy and safety of intravenous amiodarone for incessant tachycardias in infants
Efficacy and safety of intravenous amiodarone for incessant tachycardias in infants
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DOI：
10.1007/s00431-003-1302-z
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发表时间：
2003-12-01
影响因子：
3.6
通讯作者：
Bauersfeld, U
中科院分区：
文献类型：
--
作者：
Burri, S;Hug, MI;Bauersfeld, U
胺碘酮是治疗室上性和室性心动过速的有效抗心律失常药。已在成人和儿童中描述了静脉注射胺碘酮的安全性和有效性，但仅在有限程度上用于婴儿。本研究的目的是评价静脉注射胺碘酮在婴儿中的安全性和有效性。1994年2月至2001年6月，23例中位年龄为8天（范围1-300天）的婴儿，患有危及生命的持续性心动过速（17例室上性，6例室性），接受静脉注射胺碘酮作为单一抗心律失常药物治疗。就诊时，22例婴儿血流动力学不稳定。胺碘酮以5 mg/kg的静脉负荷剂量给药1小时，随后以5 μ g/kg/min的静脉维持剂量给药，逐步增加至25 μ g/kg/min，直至心律失常控制或发生副作用。胺碘酮对19例婴儿有效，3例部分有效，1例无效。心律失常控制的中位时间为24小时（范围1-96小时），中位维持剂量为15 μ g/kg/min（范围5-26 μ g/kg/min）。两名患者出现需要减少剂量的电生理副作用，包括窦性心动过缓。1例患者的低血压在剂量减少后消退。神经系统副作用包括一名婴儿的舞蹈病运动，随着时间的推移而消退。1例肝酶升高患者停用胺碘酮。结论：静脉注射胺碘酮治疗婴幼儿持续性心动过速安全有效。
Amiodarone is an effective anti-arrhythmic agent for the treatment of supraventricular and ventricular tachycardias. The safety and efficacy of intravenous amiodarone has been described in adults and children but only to a limited extent in infants. The purpose of this study was to evaluate the safety and efficacy of intravenous amiodarone in infants. Between February 1994 and June 2001, 23 infants with a median age of 8 days (range 1-300 days) with life-threatening incessant tachycardias (17 supraventricular, 6 ventricular) were treated with intravenous amiodarone as single anti-arrhythmic agent. At presentation, 22 infants were haemodynamically unstable. Amiodarone was given as an intravenous loading dose of 5 mg/kg over 1 h followed by an intravenous maintenance dose of 5 mug/kg per min with stepwise increase up to 25 mug/kg per min until arrhythmia control or side-effects occurred. Amiodarone was effective in 19 infants, partially effective in three and ineffective in one infant. The median time until arrhythmia control was 24 h (range 1-96 h) and the median maintenance dosage 15 mug/kg per min (range 5-26 mug/kg per min). Electrophysiological side-effects necessitating dose reduction comprised of sinus bradycardia in two patients. Hypotension in one patient resolved after dose diminution. Neurological side-effects consisted of choreatic movements in one infant, which resolved over time. Amiodarone administration was stopped in one patient with elevated liver enzymes. Conclusion:intravenous amiodarone is a safe and effective therapy for life-threatening incessant tachycardias in infants.