Is hypoglycemia really observed in pediatric beta-blocker intoxications? A case-control study.

Gokalp G., Nalbant T., Berksoy E., Bardak S., Demir G., Demir S., ...Daha Fazla

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, cilt.29, ss.56-60, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.arcped.2021.10.006
  • Dergi Adı: Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, PASCAL, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Sayfa Sayıları: ss.56-60
  • Anahtar Kelimeler: Beta-blocker, Intoxication, Childhood, Hypoglycemia, AMERICAN-ASSOCIATION, PROPRANOLOL, RECOGNITION, SEIZURES, EXPOSURE, AGENTS
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Background: Beta-blocker (BB) intoxications are common in both childhood and adulthood. In the case of poisoning,
bradycardia, hypotension, ventricular dysrhythmias, mental status changes, seizures, hypoglycemia,
and bronchospasm may occur. Effects on the cardiovascular system are commonly seen, but hypoglycemia is
not frequently observed in clinical practice. In this study, we aimed to answer the question, “Is hypoglycemia
more commonly observed in BB intoxications than in other intoxications?”
Method: This was a case−control study conducted in a pediatric emergency department of a university hospital.
The case group (Group 1) consisted of cases with BB poisonings and the control group (Group 2) consisted
of cases with selective serotonin receptor inhibitor (SSRI) poisonings. Data were obtained from patient files.
We recorded the blood glucose levels (BGLs) of all patients on admission to the emergency department and
at the 1-, 6-, and 24-h follow-up. The amounts of BBs received by the cases were compared with the specific
toxic doses of each drug. The data obtained were analyzed using the Statistical Package for the Social Sciences
22 (SPSS.22) program. Mean and standard deviation for numerical values and frequency for categorical data
are reported; at test, chi-square test, and ANOVA tests were used for the analysis.
Results: The study comprised 40 patients (Group 1) and 40 controls (Group 2). The mean serum BGLs of
patients in Group 1 at admission and at the 1-, 6-, and 24-h follow-up were 107.2 § 46.3 mg/dl,
86.3 § 20.1 mg/dl, 88.6 § 28.4 mg/dl, and 86.5 § 23.7 mg/dl, respectively. The mean values of Group 2 cases
were 100 § 39.5 mg/dl, 92.1 § 30 mg/dl, 91§28 mg/dl, and 127.8 § 60.7 mg/dl, respectively, at admission
and at the 1-, 6-, and 24-h follow-up (p = 0.4, p < 0.001, p = 0.7, and p < 0.001, respectively). The mean BGLs
of patients who were exposed to propranolol at admission and at the 1-, 6-, and 24-h follow-up were significantly
lower than those of the patients who had taken different BBs in Group 1. No linear correlation was
found between the percentage of exposure to BB toxic doses and BGLs.
Conclusion: Our study showed that the BGLs of patients receiving BBs could be lower, but they were not at a
level that would have serious consequences. Nevertheless, the BGLs of all cases of intoxication should be
monitored closely.