open access

Vol 50, No 4 (2018)
Original and clinical articles
Published online: 2018-09-18
Submitted: 2018-06-28
Accepted: 2018-09-18
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The effect of nebulized salbutamol on atrial electrical properties in mechanically ventilated critically ill patients — a randomized, double-blind study

Tomasz Jasiński, Radosław Owczuk, Magdalena Wujtewicz
DOI: 10.5603/AIT.a2018.0031
·
Pubmed: 30242825
·
Anaesthesiol Intensive Ther 2018;50(4):270-276.

open access

Vol 50, No 4 (2018)
Original and clinical articles
Published online: 2018-09-18
Submitted: 2018-06-28
Accepted: 2018-09-18

Abstract

Background: Salbutamol is a short acting beta-2 mimetic commonly used among intensive care unit patients. There
are data suggesting that his mechanism of action can be a potential factor triggering arrhythmias. The aim of this
study was to assess whether nebulized salbutamol causes systemic effects resulting in electrocardiographic alterations
associated with atrial fibrillation occurrence in mechanically ventilated patients.

Methods: 50 individuals were randomly allocated to receive either 2.5 or 5 mg of nebulized salbutamol for 20 minutes.
60 minutes prior to the start of nebulization, 12 lead surface electrocardiogram has been recorded. Electrocardiographic
parameters associated with atrial activity — P wave and PR interval, and their derivates: P wave dispersion
and PR interval dispersion were analysed.

Results: Both doses of inhaled salbutamol caused changes of P wave indices — maximal, minimal and mean P wave
duration, from simultaneously recorded leads, and concomitant decrease of P wave dispersion. Prolongation of
P wave affected predominantly minimal P wave duration (11.93 ms [95% CI: 8.69–15.17]) comparing with maximal
P wave duration (2.61 [95% CI: 021–5.43]). Atrio-ventricular conduction — PR interval was also prolonged, however
minimal PR interval duration from simultaneously recorded leads was shortened in group receiving 5 mg of salbutamol.

Conclusions: Nebulized salbutamol in ICU patient possess systemic effects which causes changes in P wave indices
in surface ECG recordings. This electrophysiological influence may be associated with the increased risk of atrial
fibrillation among this group of patients.

Abstract

Background: Salbutamol is a short acting beta-2 mimetic commonly used among intensive care unit patients. There
are data suggesting that his mechanism of action can be a potential factor triggering arrhythmias. The aim of this
study was to assess whether nebulized salbutamol causes systemic effects resulting in electrocardiographic alterations
associated with atrial fibrillation occurrence in mechanically ventilated patients.

Methods: 50 individuals were randomly allocated to receive either 2.5 or 5 mg of nebulized salbutamol for 20 minutes.
60 minutes prior to the start of nebulization, 12 lead surface electrocardiogram has been recorded. Electrocardiographic
parameters associated with atrial activity — P wave and PR interval, and their derivates: P wave dispersion
and PR interval dispersion were analysed.

Results: Both doses of inhaled salbutamol caused changes of P wave indices — maximal, minimal and mean P wave
duration, from simultaneously recorded leads, and concomitant decrease of P wave dispersion. Prolongation of
P wave affected predominantly minimal P wave duration (11.93 ms [95% CI: 8.69–15.17]) comparing with maximal
P wave duration (2.61 [95% CI: 021–5.43]). Atrio-ventricular conduction — PR interval was also prolonged, however
minimal PR interval duration from simultaneously recorded leads was shortened in group receiving 5 mg of salbutamol.

Conclusions: Nebulized salbutamol in ICU patient possess systemic effects which causes changes in P wave indices
in surface ECG recordings. This electrophysiological influence may be associated with the increased risk of atrial
fibrillation among this group of patients.

Get Citation

Keywords

bronchoconstriction, pharmacotherapy, salbutamol; bronchodilator agents, salbutamol; intensive care; mechanical ventilation; atrial fibrillation

About this article
Title

The effect of nebulized salbutamol on atrial electrical properties in mechanically ventilated critically ill patients — a randomized, double-blind study

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 50, No 4 (2018)

Pages

270-276

Published online

2018-09-18

DOI

10.5603/AIT.a2018.0031

Pubmed

30242825

Bibliographic record

Anaesthesiol Intensive Ther 2018;50(4):270-276.

Keywords

bronchoconstriction
pharmacotherapy
salbutamol
bronchodilator agents
salbutamol
intensive care
mechanical ventilation
atrial fibrillation

Authors

Tomasz Jasiński
Radosław Owczuk
Magdalena Wujtewicz

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