Prospective real-time evaluation of the QTc interval variation after low-dose droperidol among emergency department patients.
Prospective real-time evaluation of the QTc interval variation after low-dose droperidol among emergency department patients.
复制标题
急诊科患者低剂量滴虫后QTC间隔变化的前瞻性实时评估。
DOI：
10.1016/j.ajem.2021.12.039
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Oliveira J E Silva L
中科院分区：
文献类型：
--
作者：
Hernández-Rodríguez L;Bellolio F;Cabrera D;Mattson AE;VanMeter D;Grush AE;Oliveira J E Silva L
评估低剂量氟哌啶醇在急诊科接受氟哌啶醇治疗的未分化、稳定和非躁动患者中QTc间隔的变化。针对急性行为障碍以外的适应症接受低剂量氟哌啶醇（≤2.5 mg）治疗的≥12岁患者的前瞻性队列研究。在ED预先指定的观察期内实时监测QTc间隔。主要观察指标为氟哌啶醇给药后QTc间隔的变化，定义为QTc间隔的最大增量（变化）。其他结局包括服用氟哌啶醇后QTc≥500 ms的患者比例、δ≥+60 ms的患者比例和临床不良事件的发生率。在静脉注射后30分钟和输注后46分钟对患者进行监测。共纳入68例患者（平均年龄42.1岁，66.2%为女性）。氟哌啶醇的中位剂量为1.875 mg (0.625 mg, 2.5 mg)， 94.1%的患者接受氟哌啶醇治疗头痛。大多数患者接受哌啶醇作为2分钟丸（n = 41,60.3%）。68例患者经氟哌啶醇治疗后QTc间隔的最大δ平均值为+29.9 ms （SD 15）。在氟哌啶醇治疗后的观察期内，共有12例（17.6%）患者QTc间隔≥500 ms， 3例（4.4%）患者QTc≥+60 ms。在本研究的68名参与者中，没有发生严重的心律失常，如TdP或死亡（0/68）。然而，13.2% （n=9）至少有一个非严重不良事件，包括烦躁不安和/或焦虑。氟哌啶醇给药后QTc间期略有增加，但延长时间较短，大多在500毫秒以下，未导致严重的心律失常。在接受低剂量氟哌啶醇的患者中，持续心脏监测的产量可能很低。
To assess the QTc interval variation after low-dose droperidol in a population of undifferentiated, stable, and non-agitated patients receiving droperidol in the emergency department. Prospective cohort study of patients aged ≥ 12 years of age who received low-dose droperidol (≤ 2.5 mg) for indications other than acute behavioral disturbances. QTc intervals were monitored in real-time during pre-specified observation periods in the ED. Primary outcome was variation of QTc interval after droperidol administration, defined as the maximum delta (change) of QTc interval. Other outcomes included proportion of patients with a QTc ≥ 500 ms after droperidol, delta ≥ +60 ms, and incidence of clinical adverse events. Patients were monitored up to 30 minutes after IV bolus and up to 46 minutes after infusion. A total of 68 patients were included (mean age 42.1 years, 66.2% females). The median dose of droperidol was 1.875 mg (range 0.625 mg, 2.5 mg) and 94.1% received droperidol for headache management. Most patients received droperidol as a 2-minute bolus (n = 41, 60.3%). The mean maximum delta of QTc interval after droperidol across all 68 patients was +29.9 ms (SD 15). A total of 12 patients (17.6%) experienced a QTc interval ≥ 500 ms during the observation period after droperidol, and 3 patients (4.4%) had a delta QTc ≥ +60 ms. There were no serious arrhythmias, such as TdP, or deaths among the 68 participants in this study (0/68). However, 13.2% (n=9) had at least one non-serious adverse event including restlessness and/or anxiety. The QTc interval slightly increased after droperidol administration, but these prolongations were brief, mostly below 500 msec and did not lead to serious arrhythmias. The yield of continuous cardiac monitoring in patients receiving low doses of droperidol is likely low.
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2.1
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