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Early terbutaline in ED reduced acute respiratory failure in pediatric asthma

The early administration of continuous terbutaline in the emergency department may decrease acute respiratory failure and the need for mechanical respiratory support in severe pediatric asthma, recent data suggest.

Preventing asthma from progressing to acute respiratory failure decreases the risk for morbidity, mortality and treatment costs within the pediatric intensive care unit, according to Sule Doymaz, MD, of Cohen Children’s Medical Center of New York, and colleagues.

The researchers conducted a retrospective chart review of 120 patients (mean age, 6.8 years; 65% boys) admitted to the PICU with severe asthma who were treated with continuous intravenous terbutaline sulfate, including those from an outside hospital ED (n=35) with a late start of terbutaline and patients from Cohen Children’s ED (n=85) with early initiation of IV terbutaline. Patients who were transported from outside hospital EDs demonstrated shorter pre-PICU mean durations of IV terbutaline (0.69 hours) vs. those transferred from Cohen Children’s Medical Center (2.91 hours; P=.001)

Of the patients transferred from outside EDs, 60% required mechanical ventilation vs. 16% of patients from Cohen’s Children’s (P=.001), according to data.

The duration of pre-PICU terbutaline infusion for patients who required mechanical ventilation were significantly shorter compared with those who did not require mechanical ventilation (P=.015), the researchers wrote.

Doymaz and colleagues recommend that prospective studies be conducted to evaluate the efficacy of early administration of IV terbutaline in this patient population.

Disclosure: The researchers report no relevant financial disclosures.