Amiodarone Monitoring Practices in Pediatric Hospitals in the United States

Laboratory monitoring of amiodarone therapy is recommended due to the high incidence of adverse events associated with the drug. The use of appropriate monitoring is unknown at pediatric hospitals. The Pediatric Health Information System database was queried during a 5-year period for all patients who received amiodarone while hospitalized. Use of thyroid function testing, hepatic function testing, electrocardiogram, pulmonary function testing, and chest X-ray for patients was identified. Incidence of individual monitoring tests and complete monitoring profile was identified and compared across patient demographic and clinical factors and pediatric hospital. A total of 1,703 patients met the study criteria, and the incidence of complete amiodarone monitoring for all patients was 7.6 %. The least common monitoring test performed was triiodothyronine at 19.4 %, and the most common was electrocardiogram at 89.7 %. Critically ill patients and neonates were more likely to have amiodarone monitoring. Considerable variation in monitoring practices between pediatric hospitals was identified. Monitoring of amiodarone therapy in patients admitted to pediatric hospitals is low. Future efforts to standardize care are warranted.