2013 Volume 29 Issue 3 Pages 129-136
Background: Beta-blockers have recently become more commonly used for children with heart failure or arrhythmia.Alongside hypotension and bradycardia,hypoglycemia is a side effect of beta-blockers.Despite the potentially critical consequences of hypoglycemia,the risk factors for it resulting from beta-blzocker administration in children remain unclear.
Purpose: This study aimed to identify the risk factors for hypoglycemia as a result of the use of beta-blockers in children with Tetralogy of Fallo(t TOF).
Method: We reviewed the cases of 422 patients with TOF from 1983 through 2011 treated at our hospital.Patients were classified into 3 groups;received beta-blocker(s n = 214),received no beta-blocker(s n = 92),and with pulmonary atresia (n=116).Hypoglycemia was defined as a plasma glucose concentration of ≦40 mg/dL,or <50 mg/dl with Whipple?s triad.We analyzed the prevalence of hypoglycemia in each group and assessed factors contributing to hypoglycemia.
Results: Sixteen cases presented with hypoglycemia,all of whom received beta-blocke(r carteolol). Their mean plasma glucose was 26.4±14.1 mg/dL,mean age was 2.3±1.2 years,and mean Kaup index was 15.2±1.5.Most of the patients with hypoglycemia were on a restricted diet for cardiac catheterization or had inadequate feeding secondary to infectious disease.Hypoglycemia resulted in neurological sequelae in three cases,one of which resulted in death due to severe encephalopathy.
Conclusions: The findings indicated a relatively high incidence of hypoglycemia in infants with TOF treated with betablocker(s 7.5%),and the risk factors were inadequate feeding or starvation.Careful observation is essential for infants on beta-blockers under starving conditions.
