I have seen it but then again can't recall if the kid was < 2.
Might try Xopenex for that kid in the future..
Of course in a young child with a healthy heart, not sure 200-210 is a problem for a few hours, as long as they are well oxygenated...
I remember when I started my career, We would start aminophylline drips on kids that failed to break with 3 sub cut epi shots. if that didn't work and the kid was in severe distress, asthmatics were put on an isoproterenol drip. we would start an A line to monitor their heart rates and titrate the Isoproterenol to keep the HR at 200. Never witnessed or heard of any reactions to that protocol.
when that fell out of favor we began using tertbutaline drips for the worst cases.
of course epi was also an alternative for infusions..
with all these powerful agonist, only witnessed hr > 200 a few times..
so I am thinking in your case it was just a rare event..
Martin Herman, M.D.
Pediatric Emergency Medicine
Sacred Heart Children's Hospital
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> Date: Mon, 9 Feb 2015 18:16:24 -0500
> From: [log in to unmask]
> Subject: continuous albuterol in young asthmatics
> To: [log in to unmask]
> We are initiating continuous albuterol for asthmatics in the ED (10 mg/hr for kids < 15kg, 15 mg/hr for > 15kg). I have had 2 kids, each about 18-20 months old, develop heart rates to 210-220/min with this treatment. Neither had SVT, both were early in the process of continuous (not prolonged therapy). Has anyone had this experience with younger asthmatics? Not sure if this is just bad luck or something we should include in protocol (continuous for 2 years and older only). Would appreciate any input.
> Jim Naprawa
> Nationwide Children's Hospital
> Columbus, OH
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