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High-versus low-dose, frequently administered, nebulized albuterol in children with severe, acute asthma
Insights
High-dose nebulized albuterol (albuterol sulfate) is safe and effective for severe acute asthma in children. This treatment significantly improved lung function and reduced hospitalizations compared to low-dose albuterol.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Pharmacology
Background:
- Severe, acute asthma is a common pediatric emergency.
- Optimal dosing of nebulized albuterol for severe pediatric asthma remains under investigation.
Purpose of the Study:
- To compare the efficacy and safety of high-dose versus low-dose nebulized albuterol in children with severe, acute asthma.
Main Methods:
- Thirty-two children (5-17 years) with severe, acute asthma were randomized.
- Participants received either high-dose (0.15 mg/kg) or low-dose (0.05 mg/kg) nebulized albuterol every 20 minutes for six doses.
Main Results:
- The high-dose albuterol group showed significantly greater improvement in lung function (FEV1, FVC) and wheeze scores.
- Hospitalization rates were lower in the high-dose group.
- Adverse events (tremor, hyperactivity, vomiting) and vital sign changes were similar between groups.
Conclusions:
- High-dose, frequently administered nebulized albuterol is a safe and effective treatment for severe, acute pediatric asthma.
- This regimen offers improved clinical outcomes without increased adverse effects.
Abstract:
Thirty-two 5- to 17-year-old children who had severe, acute asthma were randomly assigned to receive either high doses (0.15 mg/kg of body weight per dose) or low doses (0.05 mg/kg of body weight per dose) of nebulized albuterol every 20 minutes for six doses. Compared with the low-dose regimen, the high-dose regimen resulted in significantly greater improvement in forced expiratory volume in 1 second, forced vital capacity, and wheeze score and a lower hospitalization rate. The changes in heart rate, respiratory rate, blood pressure, white blood cell count, and serum potassium concentration did not differ significantly between the groups. The incidence of side effects, which included tremor, hyperactivity, and vomiting, was not significantly different in the two populations. Serum albuterol levels varied widely, but there was no correlation between the levels and the increase in heart rate or other side effects. high-dose, frequently administered, nebulized albuterol appears both safe and effective in treating severe, acute asthma in children.