Habashy Doaa, Lam Lawrence T, Browne Gary J
Department of Emergency Medicine, The Children's Hospital at Westmead, Royal Alexandra Hospital for Children, Locked Bag 4001, Westmead NSW 2145, Australia.
Eur J Emerg Med. 2003 Sep;10(3):219-24. doi: 10.1097/00063110-200309000-00012.
To determine the current use of beta2-agonists, in particular salbutamol, for the management of acute asthma in children in emergency departments throughout Australia and New Zealand.
A cross-sectional survey using a questionnaire that sought to determine the current use of salbutamol and any adverse drug reactions in paediatric emergency departments.
Out of 37 hospitals eligible as paediatric emergency departments, 33 (89.1%) responded to the survey, 54.5% having guidelines for the management of acute asthma. Of the paediatric emergency departments surveyed, 45.5% used metered-dose inhaler spacer combination in the treatment of mild to moderate asthma. All paediatric emergency departments used nebulized salbutamol for acute severe asthma. In addition, 85% of paediatric emergency departments used continuous-infusion intravenous salbutamol in unresponsive patients, 63.6% administering a single-dose intravenous salbutamol bolus before commencing the infusion. District paediatric emergency departments were more likely to treat with continuous-infusion intravenous salbutamol outside of the intensive care unit. Clinical unresponsiveness to inhaled salbutamol and clinical improvement were the reported criteria in all paediatric emergency departments for the use and cessation of intravenous salbutamol. Adverse drug reactions were common: tremor (90%), hypokalaemia (45.5%) and supraventricular tachycardia (21%), particularly if continuous-infusion intravenous salbutamol administered. Eight deaths from asthma were reported, none being related to adverse drug reactions.
We report a wide variation of salbutamol use in paediatric emergency departments and a high prevalence of type A adverse drug reactions when continuous-infusion intravenous salbutamol therapy was administered. More evidence is needed on the clinical significance of the adverse effects reported in this study and optimal doses for the safe use of continuous-infusion intravenous salbutamol therapy in paediatric emergency departments.
确定在澳大利亚和新西兰各地急诊科中，β2受体激动剂，尤其是沙丁胺醇，目前在儿童急性哮喘治疗中的使用情况。
采用问卷调查进行横断面研究，旨在确定儿科急诊科中沙丁胺醇的当前使用情况及任何药物不良反应。
在37家符合儿科急诊科条件的医院中，33家（89.1%）回复了调查，其中54.5%有急性哮喘管理指南。在接受调查的儿科急诊科中，45.5%在治疗轻度至中度哮喘时使用定量吸入器加储雾罐组合。所有儿科急诊科在治疗急性重度哮喘时均使用雾化沙丁胺醇。此外，85%的儿科急诊科在无反应患者中使用持续静脉输注沙丁胺醇，63.6%在开始输注前给予单剂量静脉注射沙丁胺醇推注。地区儿科急诊科更有可能在重症监护室外使用持续静脉输注沙丁胺醇进行治疗。吸入沙丁胺醇后临床无反应和临床改善是所有儿科急诊科报告的使用和停止静脉注射沙丁胺醇的标准。药物不良反应很常见：震颤（90%）、低钾血症（45.5%）和室上性心动过速（21%），尤其是在使用持续静脉输注沙丁胺醇时。报告了8例哮喘死亡病例，均与药物不良反应无关。
我们报告了儿科急诊科中沙丁胺醇使用情况差异很大，在给予持续静脉输注沙丁胺醇治疗时，A型药物不良反应的发生率很高。需要更多证据来证明本研究中报告的不良反应的临床意义以及儿科急诊科安全使用持续静脉输注沙丁胺醇治疗的最佳剂量。
Zotero 插件