Cheewatanakornkul Sirichai, Vattanaprasan Piyanai, Uppanisakorn Supattra, Bhurayanontachai Rungsun
Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Clinical Research Center, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Acute Crit Care. 2022 Aug;37(3):391-397. doi: 10.4266/acc.2022.00080. Epub 2022 Aug 5.
Phlebitis-associated peripheral infusion of intravenous amiodarone is common in clinical practice, with an incidence between 5% and 65%. Several factors, including drug concentration, catheter size, and in-line filter used, are significantly associated with phlebitis occurrence. We performed a retrospective propensity score-matched analysis to find out whether in-line filter will reduce the incidence of amiodarone-induced phlebitis (AIP) in high concentration of amiodarone infusion compared to low concentration without in-line filter.
Clinical records of all patients who required intravenous amiodarone infusion for cardiac arrhythmias, between January 2017 to December 2019 were retrieved. The incidence of AIP was recorded and subsequently compared among high concentration (2 mg/ml) with an in-line filter and low concentration (1.5 mg/ml) infusion without an in-line filter after a 1 to 2 propensity score matched.
The data indicated that among the 214 cases of amiodarone infusion collected, 28 cases used an in-line filter with high concentration while 186 cases received a low concentration of amiodarone infusion without an in-line filter. After 1:2 propensity score matching, the incidence of phlebitis in the high concentration with in-line filter group was significantly higher than the low concentration without in-line filter group (28.6% vs. 3.6%, P<0.01).
Despite the usage of in-line filter, the high concentration of amiodarone infusion resulted in a higher incidence of peripheral phlebitis. Central venous catheterization for a high concentration of amiodarone infusion is recommended.
静脉注射胺碘酮相关的静脉炎在临床实践中很常见，发生率在5%至65%之间。包括药物浓度、导管尺寸和使用的在线过滤器在内的几个因素与静脉炎的发生显著相关。我们进行了一项回顾性倾向评分匹配分析，以确定与未使用在线过滤器的低浓度胺碘酮输注相比，在线过滤器是否会降低高浓度胺碘酮输注时胺碘酮诱导的静脉炎（AIP）的发生率。
检索了2017年1月至2019年12月期间所有因心律失常需要静脉注射胺碘酮的患者的临床记录。记录AIP的发生率，然后在1:2倾向评分匹配后，比较使用在线过滤器的高浓度（2mg/ml）和未使用在线过滤器的低浓度（1.5mg/ml）输注之间的情况。
数据表明，在收集的214例胺碘酮输注病例中，28例使用了高浓度的在线过滤器，而186例接受了低浓度的无在线过滤器的胺碘酮输注。在1:2倾向评分匹配后，使用在线过滤器的高浓度组静脉炎的发生率显著高于未使用在线过滤器的低浓度组（28.6%对3.6%，P<0.01）。
尽管使用了在线过滤器，但高浓度的胺碘酮输注导致外周静脉炎的发生率更高。建议对高浓度胺碘酮输注采用中心静脉置管。
