Abstract

PREGO, JAVIER; SEHABIAGUE, GRACIELA; DE LEONARDIS, DANIEL  and  PUJADAS, MóNICA. Tratamiento de la crisis asmática con salbutamol intravenoso y en nebulización continua en emergencia. Arch. Pediatr. Urug. [online]. 2001, vol.72, suppl.1, pp.S5-S13. ISSN 1688-1249.

Objective: evaluation of the efficacy and adverse effects of the treatment with albuterol in the severe asthmatic crisis by intravenous (IV) and continous nebulization (NC) in the emergency. Materials and methods: we studied, prospectively, patients between 0 to 14 years old, with Wood-Downes score = 5. The NC group received albuterol (0,5 mg/kg/hour) and the IV group received an initial dosis of 1 gama/kg/min, followed an maintenance dosis of 0,25-4 gammas/kg/min. Results: nine patients were included in the NC group and 7 in the IV. The medium Wood-Downes score was 5,55 in the NC and 5,42 in the IV. The efficacy of the treatment, evaluated by asthma score at 6,12 and 24 hours, showed a quick and steady improvement in both groups, without differences between them. At the beginning and at the end of the treatment, we registered average values of hemoglobin saturation, pH, pCO₂, with significant improvement in both groups, except in pCO₂. The half duration of the treatment was 13,6 hours in the NC group and 17,2 hours in the IV. No patients required mechanical ventilation assistance. We didn’t detect significant increases in heart frequency and in the CPK values. However four patients had changes in the ECG (2 of NC and 2 of IV), without clinical signals. Eight of 16 patients had hypopotasemia. Conclusions: the treatment in our series with albuterol by continous nebulization or intravenous was equally effective in the severe asthmatic crisis. Both presented adverse effects given by alterations in the ECG and hypopotasemia, without clinical signals. We didn’t detected increase in CPK values.

Keywords : ASTHMA [therapy]; ALBUTEROL [therapeutic use]; ALBUTEROL [adverse effect].

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