Determination of plasma salbutamol concentrations after nebulization in a pediatric emergency department.
OBJECTIVE
To partially validate the methodology for determining salbutamol in human plasma through high-efficiency liquid chromatography and fluorescence detection. To analyze plasma salbutamol concentrations in a group of pediatric patients with indication for nebulization in the emergency room.


METHODS
Analytical, prospective cross-sectional case series. Fifteen patients aged 12 to 37 months with a diagnosis of acute asthma crisis were selected at the Pediatric Emergency Service at Hospital da Criança Santo Antônio - Complexo Hospitalar Santa Casa, Porto Alegre, Brazil. The patients were treated following the unit's routine for the management of acute asthma crises: nebulization with salbutamol (flow rate of 6-8 L/min) (0.15 mg/kg) suspended in 4 mL of 0.9% saline solution. Nebulization was administered sequentially, three times, at 20 minute intervals. All patients were given prednisolone orally (1 mg/kg) concurrently with the nebulizations.


RESULTS
Plasma concentrations exhibited great variability in acute asthma crisis patients given three nebulizations of salbutamol (0.15 mg/kg). The mean level in plasma was 12.09 +/- 10.8 ng/mL, with a median of 8.9 ng/mL (IQ25-75% 2.75-17.65). The sample's coefficient of variation was 92.4%.


CONCLUSIONS
Post-inhalation plasma salbutamol concentrations exhibit great variation in the pediatric population, as seen in other studies. The possible causes and implications of this finding remain the subject of disagreements and of further assessments.
Rotta
Eloni T
ET
Serviço de Farmácia, Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
Amantéa
Sérgio L
SL
Froehlich
Pedro E
PE
Becker
Adriana
A
D000208:Acute Disease; D000420:Albuterol / Q000008:administration & dosage / Q000097:blood*; D001249:Asthma / Q000097:blood* / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000097:blood*; D002675:Child, Preschool; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies
D001993:Bronchodilator Agents; D000420:Albuterol