Slim Ahmad M, Roth Jason E, Duffy Benjamin, Boyd Sheri Y N, Rubal Bernard J
Cardiology Service, Brooke Army Medical Center, Fort Sam Houston, TX 78234-6200, USA.
Mil Med. 2007 Dec;172(12):1279-83.
Postoperative atrial fibrillation following cardiothoracic surgery is common and frequently managed with intravenous (IV) amiodarone. Phlebitis is the most common complication with peripheral infusion of this agent. Current practice guidelines for peripheral IV administration of <2 mg/mL amiodarone were established to reduce the risk of phlebitis. The present study examines the incidence of phlebitis in a postoperative patient population given current dose recommendations. A total of 273 patient charts were reviewed. The incidence of phlebitis in patients given IV amiodarone (n = 36) was 13.9% (95% confidence interval, 2.6-25.2%; p = 0.001). Logistic regression analysis with backward elimination of other therapeutic risk factors suggests that the odds ratio for phlebitis using current dose regimens without IV filters is 19-fold greater than baseline risk in this population. Phlebitis remains a significant complication associated with peripheral infusion of amiodarone within recommended dosing limits.
心胸外科手术后的房颤很常见,通常采用静脉注射胺碘酮进行治疗。静脉炎是外周输注该药物最常见的并发症。目前关于外周静脉注射<2mg/mL胺碘酮的实践指南旨在降低静脉炎风险。本研究调查了术后患者按照当前剂量建议用药时静脉炎的发生率。共查阅了273份患者病历。接受静脉注射胺碘酮的患者(n = 36)中静脉炎的发生率为13.9%(95%置信区间,2.6 - 25.2%;p = 0.001)。通过向后排除其他治疗风险因素的逻辑回归分析表明,在该人群中,使用当前剂量方案且未使用静脉过滤器时发生静脉炎的比值比是基线风险的19倍。在推荐剂量范围内,静脉炎仍然是外周输注胺碘酮相关的一种重要并发症。