scholarly journals Dynamics of the QTc interval over a 24‐h dose interval after start of intravenous ciprofloxacin or low‐dose erythromycin administration in ICU patients

2021 ◽  
Vol 9 (6) ◽  
Author(s):  
Florine A. Berger ◽  
Willem Weteringen ◽  
Heleen Sijs ◽  
Nicole G. M. Hunfeld ◽  
Jeroen J. H. Bunge ◽  
...  
Keyword(s):  
Low Dose ◽  
Dose Interval ◽  
Qtc Interval ◽  
Icu Patients

Prospective real-time evaluation of the QTc interval variation after low-dose droperidol among emergency department patients

2021 ◽  
Author(s):  
Luis Hernández-Rodríguez ◽  
Fernanda Bellolio ◽  
Daniel Cabrera ◽  
Alicia E. Mattson ◽  
Derek VanMeter ◽  
...  
Keyword(s):  
Emergency Department ◽  
Real Time ◽  
Low Dose ◽  
Qtc Interval ◽  
Emergency Department Patients ◽  
Time Evaluation

QTc interval changes following low-dose ondansetron administration in the emergency department

2021 ◽  
Author(s):  
Haley Sutherland ◽  
Michael Miller ◽  
Alainya Tomanec ◽  
K. Tom Xu ◽  
Tonya Barton ◽  
...  
Keyword(s):  
Emergency Department ◽  
Low Dose ◽  
Qtc Interval

Prolongation of QTc Interval after Postoperative Nausea and Vomiting Treatment by Droperidol or Ondansetron

2005 ◽  
Vol 102 (6) ◽  
pp. 1094-1100 ◽  
Author(s):  
Beny Charbit ◽  
Pierre Albaladejo ◽  
Christian Funck-Brentano ◽  
Mathieu Legrand ◽  
Emmanuel Samain ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Low Dose ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Antiemetic Drug ◽  
Electrocardiographic Monitoring ◽  
Qtc Interval Prolongation ◽  
Type 3

Background At dosages above 0.1 mg/kg, droperidol induces a dose-dependent QTc interval prolongation. Although subject to controversy, low-dose droperidol has recently been suspected to induce cardiac arrhythmias. Hence, 5-hydroxytryptamine type 3 antagonists have become the first-line drug for management of postoperative nausea and vomiting. These drugs are also known to prolong the QTc interval at high dosages. This study describes QTc interval changes associated with postoperative nausea and vomiting treatment by droperidol or ondansetron at low doses. Methods Eighty-five patients with postoperative nausea and vomiting were included in this prospective, single-blind study. Patients received either 0.75 mg intravenous droperidol (n = 43) or 4 mg intravenous ondansetron (n = 42). Electrocardiographic recordings were obtained before administration of antiemetic drug and then 1, 2, 3, 5, 10, and 15 min after. Electrocardiographic monitoring was maintained for 3 h in eight patients in each group. Results The QTc interval was prolonged (> 450 ms in men, > 470 ms in women) in 21% of the patients before antiemetic drug administration. This was significantly correlated with lower body temperature and longer duration of anesthesia. Compared with predrug QTc measurement, both antiemetics were associated with a significant QTc interval prolongation (P < 0.0001). The mean maximal QTc interval prolongation was 17 +/- 9 ms after droperidol occurring at the second minute and 20 +/- 13 ms after ondansetron at the third minute (both P < 0.0001). Compared with predrug measurement, the QTc interval was significantly lower after the 90th minute in both groups. Conclusions Droperidol and ondansetron induced similar clinically relevant QTc interval prolongations. When used in treatment of postoperative nausea and vomiting, a situation where prolongation of the QTc interval seems to occur, the safety of 5-hydroxytryptamine type 3 antagonists may not be superior to that of low-dose droperidol.

Drug-Induced QTc-Interval Prolongation in the Intensive Care Unit: Incidence and Predictors

2010 ◽  
Vol 23 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Tien M. H. Ng ◽  
Keith M. Olsen ◽  
Megan A. McCartan ◽  
Susan E. Puumala ◽  
Katie M. Speidel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Beta Blockers ◽  
Qtc Interval ◽  
Qtc Prolongation ◽  
Drug Induced ◽  
Icu Patients ◽  
End Point ◽  
Increased Risk ◽  
Qtc Interval Prolongation

There is a paucity of information regarding QTc prolongation in critically ill patients. A prospective observational study was conducted to assess the incidence and predictors of QTc prolongation associated with medications in intensive care unit (ICU) patients. Consecutive adult patients prescribed prespecified QTc-prolonging medications were assessed for development of the combined incidence of QTc >500 ms at anytime and QTc increase >60 ms above baseline. Over 3 months, 200 consecutive patients (63 ± 18 years; 52% female; 73% Caucasian; baseline QTc 447.3 ± 51.5 ms) were evaluated. The primary end point occurred in 48% of the patients (QTc >500 ms 40%, QTc increase >60 ms 29%). The majority of patients experienced a QTc >470 or 450 ms (60.5%). Mean increase in QTc at 48 hours was 20 ± 35 ms. Upon multivariate analysis, length of stay [odds ratio 1.30, 95% confidence interval (1.15, 1.47)] and baseline QTc [1.01 (1.01, 1.02)] were associated with an increased risk for the primary end point, while beta-blockers [0.41 (0.20, 0.81)] were associated with a risk reduction. In conclusion, increased risk of proarrhythmia, as assessed by QTc prolongation, occurs in the majority of ICU patients when prescribed medications with electrophysiologic properties. Increased vigilance is warranted. The possible protective effect of beta-blockers requires confirmation.

Antipyretic therapy in ICU patients: Evaluation of low dose diclofenac sodium

1986 ◽  
Vol 12 (5) ◽  
pp. 370-373 ◽  
Author(s):  
A. Pesenti ◽  
A. Riboni ◽  
E. Basilico ◽  
E. Grossi
Keyword(s):  
Low Dose ◽  
Diclofenac Sodium ◽  
Icu Patients

Evaluation of QTc Interval Prolongation Among Patients With Cancer Using Enteral Methadone

2018 ◽  
Vol 36 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Amanda G. Lovell ◽  
Bridget McCrate Protus ◽  
Maureen L. Saphire ◽  
Sachin S. Kale ◽  
Amy Lehman ◽  
...  
Keyword(s):  
Low Dose ◽  
Torsades De Pointes ◽  
High Dose ◽  
Qtc Interval ◽  
Moderate Dose ◽  
Qtc Prolongation ◽  
Patients With Cancer ◽  
Qtc Interval Prolongation ◽  
High Incidence ◽  
Clinically Significant

Context: The effect of methadone on corrected QT interval (QTc) in patients with cancer pain is not well-known. Objectives: To describe and characterize the effect of low-, moderate-, and high-dose enteral methadone on QTc interval in patients with cancer. Methods: Retrospective cohort study including patients prescribed enteral methadone during the 27-month study period. Participants were divided into 3 methadone daily dose groups: <30 (low dose), 30 to 59 (moderate dose), ≥60 (high dose) mg. The primary outcome was the incidence of QTc prolongation (>450 ms for females and >430 ms for males). Secondary outcomes included the magnitude of change in QTc after starting methadone, the incidence of clinically significant QTc prolongation (>500 ms) and the prevalence of torsades de pointes and syncope. Results: Two hundred three patients met study inclusion criteria: 91 (45%) low dose, 52 (26%) moderate dose, and 60 (29%) high dose. Incidence of QTc prolongation for low-, moderate-, and high-dose groups was 50 (55%), 37 (71%), and 43 (72%), respectively ( P = .039, low vs high dose). Incidence of clinically significant QTc prolongation was 10 (11%), 4 (8%), and 7 (12%) for low-, moderate-, and high-dose groups. For patients without QTc prolongation prior to initiating methadone, 62% of moderate-dose patients and 67% of high-dose patients had QTc prolongation, while taking methadone. Conclusion: This study found a notably high incidence of QTc prolongation in patients with cancer using enteral methadone. Future studies should aim to determine the risk of adverse cardiac effects in the cancer population and determine appropriate monitoring of methadone for pain management.

THE IMPACT OF LOW DOSE NALOXONE INFUSION ON OPIOID REQUIREMENTS IN PEDIATRIC ICU PATIENTS RECEIVING FENTANYL

2004 ◽  
Vol 32 (Supplement) ◽  
pp. A170
Author(s):  
Cindy M Darnell ◽  
Jennifer Thompson ◽  
Kristin Foglia ◽  
Lonnie Roy ◽  
Daniel Stromberg ◽  
...  
Keyword(s):  
Low Dose ◽  
Icu Patients ◽  
Pediatric Icu ◽  
The Impact

scholarly journals Activated Clotting Time (ACT) for Monitoring of Low-Dose Heparin: Performance Characteristics in Healthy Adults and Critically Ill Patients

2020 ◽  
Vol 26 ◽  
pp. 107602962097549
Author(s):  
Johannes E. Wehner ◽  
Martin Boehne ◽  
Sascha David ◽  
Korbinian Brand ◽  
Andreas Tiede ◽  
...  
Keyword(s):  
Low Dose ◽  
Ex Vivo ◽  
Limited Information ◽  
Clotting Time ◽  
Icu Patients ◽  
Dose Heparin ◽  
Activated Clotting Time ◽  
Hemorrhagic Events ◽  
High Doses ◽  
Low Dose Heparin

Dose adjustment of unfractionated heparin (UFH) anticoagulation is an important factor to reduce hemorrhagic events. High doses of heparin can be monitored by Activated Clotting Time (ACT). Because of limited information about the monitoring of low-dose heparin we assessed monitoring by ACT, aPTT and anti-Xa. Blood samples from healthy volunteers (n = 54) were treated ex vivo with increasing UFH doses (0-0.4 IU/ml). Samples from ICU-patients (n = 60), were drawn during continuous UFH infusion. Simultaneous ACT measurements were performed using iSTAT and Hemochron. In UFH treated blood, iSTAT and Hemochron showed a significant change of ACT at ≥0.075 IU/ml and ≥0.1 IU/ml UFH, respectively. In ICU-patients no relationship between ACT and either UFH dose, aPTT and anti-Xa was observed. Hemochron was affected by antithrombin and platelet count. iSTAT was sensitive to CRP and hematocrit. A moderate correlation was identified between UFH dose and aPTT (R2 = 0.196) or anti-Xa (R2 = 0.162). In heparin-spiked blood, ACT is sensitive to heparin at levels of ≥0.1 IU/ml heparin. In ICU-patients, ACT did not correlate with UFH dose or other established methods. Both systems were differently influenced by certain parameters.

Effect of low-dose cisapride on gastric emptying and QTc interval in preterm infants

2007 ◽  
Vol 89 (12) ◽  
pp. 1446-1448 ◽  
Author(s):  
C Costalos ◽  
A Gounaris ◽  
E Varhalama ◽  
F Kokori ◽  
N Alexiou ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Preterm Infants ◽  
Low Dose ◽  
Qtc Interval

URINE OUTPUT (UO) AND SERUM ALDOSTERONE (ALDO) CONCENTRATIONS IN OLIGURIC ICU PATIENTS (PTS) RECEIVING LOW DOSE DOPAMINE

1993 ◽  
Vol 21 (Supplement) ◽  
pp. S177
Author(s):  
Michael Dick ◽  
Joseph Dasta ◽  
Patricia Choban ◽  
Renu Slnha ◽  
Louis Flancbaum
Keyword(s):  
Urine Output ◽  
Low Dose ◽  
Icu Patients ◽  
Serum Aldosterone
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