Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Primary Children's Hospital, Salt Lake City, UT, USA.
J Asthma. 2021 Apr;58(4):471-480. doi: 10.1080/02770903.2019.1709867. Epub 2020 Jan 6.
Albuterol can trigger supraventricular tachycardia (SVT). The clinical characteristics, incidence, and risk factors of SVT after inhaled SABA treatment in children are currently unknown. Through review of regional care delivery, we will describe cases of SVT during asthma treatment in hospital-based settings, define the incidence of SVT in our population, and evaluate risk factors of SABA-induced SVT.
We identified hospital-based care episodes of children 0-18 years old between 2006 and 2015 recorded in the Intermountain Healthcare EDW with either 1) diagnosis codes for both asthma and SVT or 2) both SABA and adenosine listed as billed medications. Controls were matched with cases by age and sex to determine risk factors for SVT after SABA using conditional logistic regression.
Of 93 care episodes meeting criteria, we found 7 cases of SVT after SABA treatment in 6 patients over 10 years. In our population, the incidence of SVT is 3.9 per 10,000 episodes of SABA treatment, and 5.1 per 10,000 children with asthma receiving hospital-based asthma care. Two episodes of SVT followed treatment with only levalbuterol, three after only albuterol, and two after both albuterol and levalbuterol treatment. Five cases of SVT were converted to sinus rhythm with adenosine, one converted with synchronized electrical cardioversion, and one resolved spontaneously. No cases of SVT led to death. No examined variables were associated with SABA-induced SVT.
SVT is rare during hospital-based treatment for acute asthma using inhaled SABAs and has low morbidity and mortality.
沙丁胺醇可引发室上性心动过速（SVT）。目前，尚不清楚儿童吸入 SABA 治疗后 SVT 的临床特征、发生率和危险因素。通过对区域性医疗服务的回顾，我们将描述在医院环境中治疗哮喘期间 SVT 的病例，确定我们人群中 SVT 的发生率，并评估 SABA 引起 SVT 的危险因素。
我们在 Intermountain Healthcare EDW 中确定了 2006 年至 2015 年间患有哮喘和 SVT 的诊断代码，或 1）同时记录沙丁胺醇和腺苷作为计费药物的 0-18 岁儿童的住院治疗记录。通过条件逻辑回归，将对照与病例按年龄和性别匹配，以确定 SABA 后 SVT 的危险因素。
在符合标准的 93 个护理事件中，我们发现 6 名 10 岁以上患者在接受 SABA 治疗后有 7 例 SVT。在我们的人群中，SVT 的发生率为每 10,000 次 SABA 治疗 3.9 例，每 10,000 名接受医院哮喘治疗的哮喘儿童中有 5.1 例。两例 SVT 紧随仅使用左旋沙丁胺醇治疗后发生，三例紧随仅使用沙丁胺醇治疗后发生，两例紧随沙丁胺醇和左旋沙丁胺醇治疗后发生。五例 SVT 用腺苷转为窦性心律，一例用同步电复律转为窦性心律，一例自行缓解。无 SVT 导致死亡病例。未检查的变量与 SABA 引起的 SVT 无关。
在使用吸入性 SABA 治疗急性哮喘的住院治疗中，SVT 很少见，且发病率和死亡率都很低。
