Use of Arginine Hydrochloride in the Treatment of Metabolic Alkalosis or Hypochloremia in Pediatric Patients
| Autor: | Caroline M. Sierra, Kristine A Parbuoni, Elvin A. Hernandez |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
ARGININE HYDROCHLORIDE Arginine business.industry Bicarbonate Hypochloremia Metabolic alkalosis Clinical Investigations 030204 cardiovascular system & hematology medicine.disease Single Center Gastroenterology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry Internal medicine Pediatrics Perinatology and Child Health medicine Serum chloride Pharmacology (medical) 030212 general & internal medicine Dosing business |
| Zdroj: | The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG. 23(2) |
| ISSN: | 1551-6776 |
| Popis: | OBJECTIVES Dosing of arginine for treatment of hypochloremia or metabolic alkalosis is laborious and has inherent variability in dose selection. The primary objective of this study was to determine the efficacy of arginine in the treatment of metabolic alkalosis and hypochloremia. Secondary objectives were to determine an optimal dose, route, and frequency for arginine administration in the treatment of these conditions.METHODS This single center, retrospective, descriptive study was conducted in children who received arginine for treatment of hypochloremia or metabolic alkalosis. Treatment success was assessed by measuring serum chloride and bicarbonate concentrations after arginine administration.RESULTS Of the 464 orders analyzed, 177 met inclusion criteria in 82 unique patients. Fifty percent (n = 81) of arginine administrations used to manage hypochloremia saw normalization of abnormal chloride levels, and 83% (n = 62) of arginine administrations used to treat metabolic alkalosis saw normalization of abnormal bicarbonate levels. Patients who received arginine to resolve hypochloremia were statistically significantly more likely to have their hypochloremia resolve if they used alternative dosing methods compared to established dosing methods (76 vs. 5, p = 0.001). However, this relationship was not seen for patients with metabolic alkalosis (11 vs. 51, p = 1.000). The median percentage of calculated daily dose of arginine needed for resolution of hypochloremia was 59% and was 35% for metabolic alkalosis.CONCLUSIONS Arginine is effective to improve metabolic alkalosis and hypochloremia. Established dosing methods are not more effective than other methods in resolving metabolic alkalosis or hypochloremia. Further prospective studies are warranted to validate these results. |
| Databáze: | OpenAIRE |
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