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AAP Grand Rounds 4:32-33 (2000)
© 2000 American Academy of Pediatrics

CRITICAL CARE

Intravenous Terbutaline for Severe, Unresponsive Asthma

Source: Chiang VW, Burns JP, Rifai N, et al. Cardiac toxicity of intravenous terbutaline for the treatment of severe asthma in children: a prospective assessment. J Pediatr. 2000;137:73–77.

The first 20% of the full text of this article appears below.

The authors prospectively enrolled 29 children (mean age 9.1 years) treated at Children’s Hospital, Boston, MA, who were to receive intravenous terbutaline for severe status asthmaticus that had not improved after administration of corticosteroids and inhaled ß2 agonists (albuterol). Baseline measurement of cardiac troponin (cTnT) which appears to be a specific biochemical marker of cardiac injury, creatine kinase (CK), creatine kinase myocardial band (CK MB) and electrocardiography (EKG) were obtained. These measurements were repeated daily while on intravenous terbutaline. Patients received a loading dose of terbutaline (10mcg/kg) over 10 minutes and then an infusion was started at 0.4 mcg/kg/min. The dose was increased by 0.2 mcg/kg/min until the child improved. The patients continued to receive inhaled albuterol at 0.5 mg/kg/hour and corticosteroids (mean dose 2.9 mg/kg/d for enrolled patients).

The authors reported that 19/29 baseline EKGs revealed possible signs of . . . [Full Text of this Article]

Susan L. Bratton, MD, FAAP
Pediatric Critical Care Medicine, University of Michigan and Mott Children’s Hospital, Ann Arbor, MI