Transient occult cardiotoxicity in children receiving continuous beta-agonist therapy
Christopher L Carroll1, Melinda Coro, Allison Cowl
1Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT, USA, ccarrol@ccmckids.org.
World Journal of Pediatrics : WJP
|March 7, 2014
Summary
Continuous beta-agonist therapy in children can cause temporary increases in troponin-T and lactate levels. These levels normalize within 48 hours and do not impact hospital stay, suggesting a low risk of cardiotoxicity.
Area of Science:
- Pediatric critical care medicine
- Pharmacology and toxicology
Background:
- Continuous beta-agonist therapy, primarily inhaled albuterol, is a standard treatment for pediatric bronchospasm.
- Concerns exist regarding potential cardiotoxicity associated with this therapy.
Purpose of the Study:
- To investigate the cardiotoxic effects of continuous beta-agonist therapy in pediatric intensive care unit (ICU) patients.
Main Methods:
- Retrospective review of 36 children in the ICU receiving continuous beta-agonist therapy (inhaled and/or intravenous).
- Monitoring of serum troponin-T and lactate levels during treatment.
Main Results:
- Elevated troponin-T (25%) and lactate (60%) levels were observed in children receiving continuous albuterol.
- These elevated levels normalized within 48 hours of ICU admission, despite ongoing therapy.
- No arrhythmias were reported, and no association was found between terbutaline use and elevated markers or increased hospital length of stay.
Conclusions:
- Continuous beta-agonist therapy in children can lead to transient elevations in troponin-T and lactate.
- These biochemical changes appear to be temporary and not associated with adverse clinical outcomes like arrhythmias or prolonged hospitalization.
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