Intravenous salbutamol for childhood asthma: evidence-based medicine?

Arch Dis Child. 2014 Sep;99(9):873-7. doi: 10.1136/archdischild-2013-304467. Epub 2014 Jun 17.

Abstract

Intravenous salbutamol is commonly used to treat children with severe asthma unresponsive to inhaled β2-agonist therapy. However, in this setting, there is little clinical trial data demonstrating its effectiveness. Additionally, there are significant concerns that intravenous salbutamol-dosing recommendations for children with acute asthma are excessive, and unnecessarily raise the potential for adverse reactions, such as lactic acidosis and tachycardia which, by increasing respiratory workload, exacerbate respiratory failure. Here, we review salbutamol clinical pharmacology and toxicology, evidence relating to its use in acute asthma and highlight gaps in the evidence base.

Keywords: Evidence Based Medicine; Pharmacology; Respiratory.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Adrenergic beta-2 Receptor Agonists / adverse effects
  • Adrenergic beta-2 Receptor Agonists / therapeutic use*
  • Albuterol / adverse effects
  • Albuterol / therapeutic use*
  • Asthma / drug therapy*
  • Child
  • Child, Preschool
  • Evidence-Based Medicine
  • Humans
  • Infusions, Intravenous
  • Treatment Outcome

Substances

  • Adrenergic beta-2 Receptor Agonists
  • Albuterol