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Terbutaline and aminophylline as second-line therapies for status asthmaticus in the pediatric intensive care unit

Casey Stulce1, Suzanne Gouda1, Sana J Said2

  • 1Section of Pediatric Critical Care, Department of Pediatrics, University of Chicago, Chicago, Illinois.

Pediatric Pulmonology
|May 20, 2020
PubMed

Insights

Aminophylline may be a better second-tier therapy than terbutaline for pediatric patients with severe asthma (status asthmaticus). This is especially true for African American children, who had lower intubation rates with aminophylline.

Area of Science:

  • Pediatric Intensive Care
  • Pulmonology
  • Pharmacology

Background:

  • Asthma is a leading chronic childhood illness.
  • Pediatric intensive care unit (PICU) admissions for asthma are rising.
  • No current guidelines exist for escalating asthma therapies in PICU.

Purpose of the Study:

  • To compare outcomes of aminophylline versus terbutaline as second-tier therapies for status asthmaticus.
  • To assess the efficacy of these treatments in pediatric patients.
  • To identify potential disparities in treatment effectiveness.

Main Methods:

  • Retrospective cohort study (2016-2019).
  • Utilized data from the Pediatric Health Information System.
  • Included 1144 pediatric patients (2-18 years) with status asthmaticus treated in 53 tertiary children's hospitals.

Main Results:

  • No significant difference in intubation/mechanical ventilation between aminophylline and terbutaline overall.
  • African American patients receiving terbutaline had significantly higher odds of intubation (OR 12.41).
  • Aminophylline use was associated with lower intubation odds in this subgroup.

Conclusions:

  • Aminophylline may be preferred over terbutaline for African American children with status asthmaticus.
  • Further research is needed to confirm these findings and guide therapy.
  • This study highlights potential ethnic disparities in asthma treatment outcomes.
Abstract

Keywords:
asthmamethylxanthinepediatric critical carestatus asthmaticus

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