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Journal article

Selective ß2-adrenoceptor agonists and relevant hyperlactatemia : systematic review and meta-analysis

  • Liedtke, Alina G. Department of Internal Medicine, Ente Ospedaliero Cantonale, 6600 Locarno, Switzerland
  • Lava, Sebastiano A. G. Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, and University of Lausanne, 1010 Lausanne, Switzerland
  • Milani, Gregorio P. Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy - Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
  • Agostoni, Carlo Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy - Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
  • Gilardi, Viola Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
  • Bianchetti, Mario G. Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, 6500 Bellinzona
  • Treglia, Giorgio Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland - Faculty of Biology and Medicine, University of Lausanne, 1000 Lausanne, Switzerland
  • Faré, Pietro B. Department of Internal Medicine, Ente Ospedaliero Cantonale, 6600 Locarno, Switzerland
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    27.12.2019
Published in:
  • Journal of clinical medicine. - 2020, vol. 9, no. 1, p. 71
Acidosis
Kussmaul breathing
Lactate
Lactic acid
ß2-adrenoceptor agonist
English Selective ß2-agonists have been imputed as potential cause of l-hyperlactatemia since the 1970s. To document the prevalence of hyperlactatemia associated with selective ß2-agonists and to investigate the predisposing factors, we searched for published articles until April 2019 pertaining to the interplay of administration of selective ß2-agonists and circulating l-lactic acid in the Excerpta Medica, Web of Science, and the U.S. National Library of Medicine databases. Out of the 1834 initially retrieved records, 56 articles were included: 42 papers reporting individual cases, 2 observational studies, and 12 clinical trials. Forty- seven individual patients receiving a selective ß2-agonist were found to have l-lactatemia ≥5.0 mmol/L, which decreased by ≥3.0 mmol/L or to ≤2.5 mmol/L after discontinuing (N = 24), reducing (N = 17) or without modifying the dosage of the selective ß2-agonist (N = 6). Clinical trials found that l-lactic acid significantly increased in healthy volunteers administered a ß2-agonist. l-lactatemia ≥5.0 mmol/L was observed in 103 (24%) out of 426 patients with asthma or preterm labor managed with a selective ß2-agonist and was more common in patients with asthma (30%) than in premature labor (5.9%). A significant relationship was also noted between l-lactate level and intravenous albuterol dose or its circulating level. In conclusion, relevant l-hyperlactatemia is common on high dose treatment with a selective ß2-agonist.
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  • English
Classification
Medicine
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https://n2t.net/ark:/12658/srd1319144
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