Evelien Hoogstraaten1, Saskia Rijkenberg2, Peter H J van der Voort3. 1. Dept of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. Electronic address: evelien.hoogstraaten@live.nl. 2. Dept of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. Electronic address: s.rijkenberg@olvg.nl. 3. Dept of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. Electronic address: p.h.j.vandervoort@olvg.nl.
Abstract
PURPOSE: Critically ill patients are at risk for prolongation of the interval between the Q wave and the T wave in the electrocardiogram (corrected QT [QTc]). Corrected QT prolongation is probably a dynamic process. It is unknown how many patients have a QTc prolongation during their intensive care stay and how variable QTc prolongation is. MATERIALS AND METHODS: In a prospective cohort study, continuous 5-minute QTc measurements of 50 consecutive patients were collected. A prolonged QTc interval was more than 500 milliseconds for at least 15 minutes. The QT variance and variability index was used to evaluate QTc variation. RESULTS: Fifty-two percent of included patients had a prolonged QTc interval. In a single patient, 0.2% to 91.3% of the QTc intervals over time were prolonged. The use of erythromycin and amiodarone was associated with the mean QTc (P = .02 and P = .006, respectively). The Acute Physiology and Chronic Health Evaluation IV and Sequential Organ Failure Assessment scores were significantly higher in patients with a prolonged QTc interval (30.8 vs 8.6 and 7 vs 5.5, respectively). Eighty-four percent of all patients received at least 1 QTc-prolonging drug. The QT variance and QTc variance were significantly higher in patients with a prolonged QTc (P = .019 and P = .001, respectively). CONCLUSION: Continuous QTc monitoring showed a prolonged QTc interval in 52% of intensive care patients. Severity of illness and QT and QTc variances are higher in these patients.
PURPOSE:Critically illpatients are at risk for prolongation of the interval between the Q wave and the T wave in the electrocardiogram (corrected QT [QTc]). Corrected QT prolongation is probably a dynamic process. It is unknown how many patients have a QTc prolongation during their intensive care stay and how variable QTc prolongation is. MATERIALS AND METHODS: In a prospective cohort study, continuous 5-minute QTc measurements of 50 consecutive patients were collected. A prolonged QTc interval was more than 500 milliseconds for at least 15 minutes. The QT variance and variability index was used to evaluate QTc variation. RESULTS: Fifty-two percent of included patients had a prolonged QTc interval. In a single patient, 0.2% to 91.3% of the QTc intervals over time were prolonged. The use of erythromycin and amiodarone was associated with the mean QTc (P = .02 and P = .006, respectively). The Acute Physiology and Chronic Health Evaluation IV and Sequential Organ Failure Assessment scores were significantly higher in patients with a prolonged QTc interval (30.8 vs 8.6 and 7 vs 5.5, respectively). Eighty-four percent of all patients received at least 1 QTc-prolonging drug. The QT variance and QTc variance were significantly higher in patients with a prolonged QTc (P = .019 and P = .001, respectively). CONCLUSION: Continuous QTc monitoring showed a prolonged QTc interval in 52% of intensive care patients. Severity of illness and QT and QTc variances are higher in these patients.
Authors: Florine A Berger; Willem van Weteringen; Heleen van der Sijs; Nicole G M Hunfeld; Jeroen J H Bunge; Natasja M S de Groot; Patricia M L A van den Bemt; Teun van Gelder Journal: Pharmacol Res Perspect Date: 2021-12