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[Continuous subcutaneous infusion of beta 2-agonists in infantile asthma]
F Bremont1, C Pienkowski, V Moisan
1Unité des Maladies Respiratoires et Allergiques de l'Enfant et de l'Adolescent, CHU Rangueil, Toulouse.
Insights
Continuous subcutaneous infusion of beta 2-agonists offers a safe and effective treatment for severe infantile asthma attacks unresponsive to nebulization. This method provides mobility and avoids administration issues, proving useful in various therapeutic combinations.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Critical Care Medicine
Context:
- Severe asthma attacks in infants often present challenges with traditional beta 2-agonist delivery methods like nebulization.
- Infants may experience infusion or nebulization difficulties, alongside bronchial stasis, complicating asthma management.
- Existing treatment protocols for severe infantile asthma require optimization for efficacy and patient comfort.
Purpose:
- To evaluate the efficacy and safety of continuous subcutaneous infusion of beta 2-agonists in infants experiencing severe asthma attacks.
- To assess this novel administration route as a viable alternative when standard nebulization methods fail or are problematic.
- To determine the utility of continuous subcutaneous infusion as monotherapy or adjunct therapy in infantile asthma management.
Summary:
- Five infants (7-17 months) with severe asthma attacks received continuous subcutaneous infusion of a beta 2-agonist (0.1 microgram/kg/min) for 6-11 days.
- This method proved effective, even in cases with prior infusion/nebulization issues or bronchial stasis, with no adverse effects noted.
- The treatment facilitated patient mobility and was successfully integrated into protocols with antibiotics, steroids, and theophylline.
Impact:
- Continuous subcutaneous infusion of beta 2-agonists presents a promising new therapeutic option for severe infantile asthma, particularly when nebulization is ineffective.
- This administration route enhances patient comfort and mobility, addressing limitations of conventional methods.
- Further research with larger patient cohorts is warranted to fully define the role and indications of this treatment in infantile asthma care.
Abstract:
Five infants aged 7 to 17 months were treated for asthma with a continuous subcutaneous infusion of a beta 2-agonist for 6 to 11 days in a dosage of 0.1 microgram/kg/mn. The patients had a severe attack of asthma with problems with infusions and/or problems with nebulizations of beta 2-agonists and/or bronchial stasis. No local or systemic adverse effects were recorded. This mode of administration of beta 2-agonists proved extremely useful, either as single therapy or as part of a therapeutic protocol including antibiotics, steroids and theophylline. It avoids the problems met with administration of beta 2-agonists by the other routes and allows the child freedom of movement. The main indication is the severe attack of asthma that fails to respond to nebulizations. We suggest this new therapeutic method should be included in the therapeutic armamentarium for infantile asthma, although its exact place and indications need to be further defined by studies in a larger number of patients.