Parker N, Flowers R, Vickery K, Stolfi A, Bugnitz C
Wright State University Boonshoft School of Medicine, Dayton, OH, USA.
Dayton Children's Hospital, Dayton, OH, USA.
Pediatr Cardiol. 2023 Apr;44(4):836-844. doi: 10.1007/s00246-023-03142-9. Epub 2023 Mar 18.
Supraventricular tachycardia (SVT) is the most common arrhythmia among infants. Prevention of SVT is frequently managed through propranolol therapy. Hypoglycemia is a known adverse effect of propranolol therapy, but little research has been done on the incidence and risk of hypoglycemia in treatment of SVT in infants with propranolol. This study attempts to offer insight into the risk of hypoglycemia associated with propranolol therapy when treating infantile SVT to help inform future glucose screening guidelines. We conducted a retrospective chart review of infants treated with propranolol in our hospital system. Inclusion criteria were infants < 1 year of age who received propranolol for the treatment of SVT. A total of 63 patients were identified. Data was collected on sex, age, race, diagnosis, gestational age, nutrition source (Total Parenteral Nutrition (TPN) vs oral), weight (kg), weight for length (kg/cm), propranolol dose (mg/kg/day), comorbidities, and whether or not a hypoglycemic event was identified (< 60 mg/dL). Hypoglycemic events were identified in 9/63 (14.3%) patients. Of the patients with hypoglycemic events, 9/9 (88.9%) had comorbid conditions. Patients with hypoglycemic events had significantly lower weight and propranolol dose than those without hypoglycemic events. Weight for length also tended to increase risk for hypoglycemic events. The high incidence of comorbid conditions in the patients who had hypoglycemic events suggests that hypoglycemic monitoring may only be necessary in patients with conditions predisposing to hypoglycemia.
室上性心动过速（SVT）是婴儿中最常见的心律失常。SVT的预防通常通过普萘洛尔治疗来进行。低血糖是普萘洛尔治疗已知的不良反应，但关于普萘洛尔治疗婴儿SVT时低血糖的发生率和风险的研究很少。本研究试图深入了解在治疗婴儿SVT时与普萘洛尔治疗相关的低血糖风险，以帮助为未来的血糖筛查指南提供信息。我们对我院系统中接受普萘洛尔治疗的婴儿进行了回顾性病历审查。纳入标准为年龄小于1岁、因治疗SVT而接受普萘洛尔治疗的婴儿。共确定了63例患者。收集了有关性别、年龄、种族、诊断、胎龄、营养来源（全胃肠外营养（TPN）与口服）、体重（kg）、身长体重比（kg/cm）、普萘洛尔剂量（mg/kg/天）、合并症以及是否发生低血糖事件（<60mg/dL）的数据。在9/63（14.3%）的患者中发现了低血糖事件。在发生低血糖事件的患者中，9/9（88.9%）有合并症。发生低血糖事件的患者的体重和普萘洛尔剂量显著低于未发生低血糖事件的患者。身长体重比也往往增加低血糖事件的风险。发生低血糖事件的患者中合并症的高发生率表明，可能仅需对有低血糖倾向的患者进行低血糖监测。
