Repeated doses of salbutamol and aeroallergen sensitisation both increased salbutamol-induced hypoxia in children and adolescents with acute asthma

Acta Paediatr. 2018 Apr;107(4):647-652. doi: 10.1111/apa.14202. Epub 2018 Jan 17.


Aim: We aimed to identify the frequency, magnitude and risk factors of salbutamol-induced hypoxia in children with acute asthma.

Methods: This study was conducted at Hacettepe University on children who presented to the paediatric allergy clinic or the paediatric emergency room with acute asthma between July 2014 and June 2015. Vital signs, pulse oximetry-defined oxygen saturation and modified pulmonary index scores were evaluated before and after the first, second and third doses of nebulised salbutamol and repeated one and 10 days later.

Results: We included 304 patients (65.7% male) from median age of 5.3 years (range 1-18 years). Salbutamol-induced hypoxia was detected in 14.7%, 3.9% and 1.3%, respectively, after the first, second and third doses of salbutamol. The risk factors for hypoxia were younger age and a higher modified pulmonary index score, but the risk factors for salbutamol-induced hypoxia were the number of salbutamol doses given in the last six hours and the presence of aeroallergen sensitisation. The maximum decrease in oxygen saturation after salbutamol was %5.

Conclusion: Although bronchodilators are the first-line treatment for acute asthma, they caused modest hypoxaemia, especially at repeated doses and, or, in patients with aeroallergen sensitisation.

Keywords: Asthma; Children; Hypoxia; Modified pulmonary index score; Salbutamol.

MeSH terms

  • Acute Disease
  • Administration, Inhalation
  • Adolescent
  • Albuterol / administration & dosage*
  • Asthma / complications
  • Asthma / drug therapy*
  • Bronchodilator Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Drug Administration Schedule
  • Female
  • Humans
  • Hypoxia / diagnosis*
  • Hypoxia / etiology*
  • Infant
  • Male
  • Nebulizers and Vaporizers
  • Oximetry
  • Prospective Studies
  • Risk Factors


  • Bronchodilator Agents
  • Albuterol