• Evelien Hoogstraaten, Saskia Rijkenberg, and Peter H J van der Voort.
• Dept of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. Electronic address: evelien.hoogstraaten@live.nl.
• J Crit Care. 2014 Oct 1;29(5):835-9.

PurposeCritically ill patients are at risk for prolongation of the interval between the Q wave and the T wave in the electrocardiogram (corrected QT [QTc]). Corrected QT prolongation is probably a dynamic process. It is unknown how many patients have a QTc prolongation during their intensive care stay and how variable QTc prolongation is.Materials And MethodsIn a prospective cohort study, continuous 5-minute QTc measurements of 50 consecutive patients were collected. A prolonged QTc interval was more than 500 milliseconds for at least 15 minutes. The QT variance and variability index was used to evaluate QTc variation.ResultsFifty-two percent of included patients had a prolonged QTc interval. In a single patient, 0.2% to 91.3% of the QTc intervals over time were prolonged. The use of erythromycin and amiodarone was associated with the mean QTc (P = .02 and P = .006, respectively). The Acute Physiology and Chronic Health Evaluation IV and Sequential Organ Failure Assessment scores were significantly higher in patients with a prolonged QTc interval (30.8 vs 8.6 and 7 vs 5.5, respectively). Eighty-four percent of all patients received at least 1 QTc-prolonging drug. The QT variance and QTc variance were significantly higher in patients with a prolonged QTc (P = .019 and P = .001, respectively).ConclusionContinuous QTc monitoring showed a prolonged QTc interval in 52% of intensive care patients. Severity of illness and QT and QTc variances are higher in these patients.Copyright © 2014 Elsevier Inc. All rights reserved.

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