Schnaubelt Sebastian, Eibensteiner Felix, Oppenauer Julia, Tihanyi Daniel, Neymayer Marco, Brock Roman, Kornfehl Andrea, Veigl Christoph, Al Jalali Valentin, Anders Sonja, Steinlechner Barbara, Domanovits Hans, Sulzgruber Patrick
Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Department of Pulmonology, Clinic Penzing, Vienna Healthcare Group, 1140 Vienna, Austria.
Pharmaceuticals (Basel). 2023 Jan 17;16(2):134. doi: 10.3390/ph16020134.
The highly β1-selective beta-blocker Landiolol is known to facilitate efficient and safe rate control in non-compensatory tachycardia or dysrhythmia when administered continuously. However, efficacy and safety data of the also-available bolus formulation in critically ill patients are scarce.
We conducted a retrospective cross-sectional study on a real-life cohort of critical care patients, who had been treated with push-dose Landiolol due to sudden-onset non-compensatory supraventricular tachycardia. Continuous hemodynamic data had been acquired via invasive blood pressure monitoring.
Thirty patients and 49 bolus applications were analyzed. Successful heart rate control was accomplished in 20 (41%) cases, rhythm control was achieved in 13 (27%) episodes, and 16 (33%) applications showed no effect. Overall, the heart rate was significantly lower (145 (130-150) vs. 105 (100-125) bpm, < 0.001) in a 90 min post-application observational period in all subgroups. The median changes in blood pressure after the bolus application did not reach clinical significance. Compared with the ventilation settings before the bolus application, the respiratory settings including the required FiO after the bolus application did not differ significantly. No serious adverse events were seen.
Push-dose Landiolol was safe and effective in critically ill ICU patients. No clinically relevant impact on blood pressure was noted.
高β1选择性β受体阻滞剂兰地洛尔已知在持续给药时可促进非代偿性心动过速或心律失常的有效且安全的心率控制。然而，关于其推注剂型在重症患者中的疗效和安全性数据却很匮乏。
我们对一组重症监护患者的真实队列进行了回顾性横断面研究，这些患者因突发非代偿性室上性心动过速接受了推注剂量的兰地洛尔治疗。通过有创血压监测获取连续的血流动力学数据。
分析了30例患者和49次推注应用情况。20例（41%）患者成功实现心率控制，13次（27%）发作实现节律控制，16次（33%）应用无效。总体而言，在所有亚组应用后的90分钟观察期内，心率显著降低（145（130 - 150）对105（100 - 125）次/分钟，<0.001）。推注应用后血压的中位数变化未达到临床意义。与推注应用前的通气设置相比，推注应用后的呼吸设置包括所需的FiO2没有显著差异。未观察到严重不良事件。
推注剂量的兰地洛尔在重症ICU患者中安全有效。未发现对血压有临床相关影响。
