ETIOLOGY AND PREVENTION OF PULMONARY COMPLICATIONS FOLLOWING BETA-MIMETIC MEDIATED TOCOLYSIS

Objectives: This study documents biological (haematocrit variations) a nd therapeutic parameters (salbutamol doses, volumes perfused) in two groups tocolysed with salbutamol, one with and the other without APO i n order to define the risk factors linked to APO and to establish a st andard protocol of management. Study design: This retrospective study includes data from 68 intravenous salbutamol tocolysis with four resul ting APOs, carried out between January 1st, 1993 and December 31st, 19 95. Results: There was an excessive level of salbutamol administered o ver 48 h in the complicated APO-group (122.5+/-52 mg) opposed to the n on-APO group (44.9+/-21 mg) as well as an overload of perfused solute (3.1+/-1.11) versus (1.9+/-1.11). Blood hemodilution was demonstrated in the APO group with a decrease of haematocrit by over 10% between th e admission and the control value. No other risk factor was found. Con clusion: Tocolysis should be administered at the lowest possible perfu sion rate with incremental doses as long as the heart rate stays under 120 beats/min and stopped after 48 h. Administration of maximal 11 of solute perfused/day is recommended. For the patient's follow-up we es timate daily input and output fluid to avoid hydric overload, and a da ily control of haematocrit whose variation must be less than 10%. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.