Wiley J F, Spiller H A, Krenzelok E P, Borys D J
Section of Emergency Medicine, St. Christopher's Hospital for Children, Temple University School of Medicine, Philadelphia, PA 19134.
Pediatr Emerg Care. 1994 Aug;10(4):193-6. doi: 10.1097/00006565-199408000-00002.
This study was designed to determine the threshold dose for toxicity, the potential for serious medical complications, and the medical care required after unintentional albuterol ingestion in children. This study was prospective and descriptive. Data were obtained on pediatric albuterol ingestions evaluated emergently as reported to three regional poison control centers. Data elements included dose ingested, physical findings, medical treatment, and outcome. During 18 months, 78 patients who ingested albuterol and who received urgent medical evaluation were identified. Mean age was 2.8 years. The amount ingested ranged from 0.2 to 8.8 mg/kg. The most commonly reported signs of toxicity were tachycardia (57%, 44/78), widened pulse pressure (50%, 27/54), hyperglycemia (50%, 12/24), agitation (45%, 35/78), low serum carbon dioxide (42%, 10/24), vomiting (26%, 20/78), and hypokalemia (26%, 9/35). We found a threshold dose o 1 mg/kg for three or more signs of toxicity (P < 0.01). No patient required any specific treatment for toxicity. Seventy-two percent of patients were discharged from medical care within six hours of ingestion. Albuterol overdose in children causes a variety of cardiovascular, neuromuscular, and metabolic effects that are usually benign. The threshold dose for the development of three or more signs of toxicity is 1 mg/kg or three to 10 times the recommended daily dose. Toxicity is short-lived and does not require specific therapy or hospital admission in most cases.
本研究旨在确定儿童意外摄入沙丁胺醇后的毒性阈值剂量、严重医学并发症的可能性以及所需的医疗护理。本研究为前瞻性描述性研究。收集了向三个地区毒物控制中心报告的因沙丁胺醇摄入而紧急评估的儿科病例数据。数据元素包括摄入剂量、体格检查结果、医学治疗及转归。在18个月期间，共识别出78例摄入沙丁胺醇并接受紧急医学评估的患者。平均年龄为2.8岁。摄入剂量范围为0.2至8.8mg/kg。最常报告的毒性体征为心动过速（57%，44/78）、脉压增宽（50%，27/54）、高血糖（50%，12/24）、烦躁不安（45%，35/78）、血清二氧化碳降低（42%，10/24）、呕吐（26%，20/78）和低钾血症（26%，9/35）。我们发现，出现三种或更多毒性体征的阈值剂量为1mg/kg（P<0.01）。没有患者因毒性需要任何特殊治疗。72%的患者在摄入后6小时内出院。儿童沙丁胺醇过量会导致多种通常为良性的心血管、神经肌肉和代谢影响。出现三种或更多毒性体征的阈值剂量为1mg/kg，即推荐日剂量的3至10倍。毒性是短暂的，在大多数情况下不需要特殊治疗或住院。
