Esmolol Infusion in Pediatric Intensive Care; 2 Years Retrospective Review

Abstract

Objective: Esmolol is an exceptionally effective cardio-selective β (1)-receptor blocking agent that demonstrates a swift onset and a brief duration of action. Our goal in this research was to delve into the utilization of esmolol, a potent intravenous beta blocker agent, among pediatric patients in the intensive care unit who possess various medical conditions. Method: Our research conducted over a span of two years between December 2020 and 2022, took place at the pediatric intensive care unit (PICU). The demographics, primary diagnoses, intensive care admission diagnoses, blood pressure levels, indications for starting esmolol, echocardiographic imaging findings of patients using esmolol infusion, esmolol doses, duration of use, reason for discontinuation, need for mechanical ventilation, use of inotropes, and pediatric risk of mortality score IV scores of patients using esmolol infusion were recorded in the data set. Results: The lowest starting dose of esmolol infusion (n=37) was determined as 25 mcg/kg/min and the highest dose as 250 mcg/kg/min. The median age of the deceased patients was significantly high. Additionally, the esmolol infusion doses of the surviving patients were higher. In the surviving patients, the median esmolol dose was found to be significantly higher, while the median age was significantly lower. Conclusion: The use of esmolol through intravenous infusion in PICUs requires careful consideration and monitoring of the patient’s hemodynamic and clinical parameters. Our experience has shown that esmolol can effectively regulate heart rate at low dosages.

Keywords

• esmolol
• pediatric intensive care
• tachycardia