title: Safety of Terbutaline for Treatment of Acute Severe Pediatric Asthma.
abstract: OBJECTIVE
  The use of continuous intravenous terbutaline treatment in severe asthma attacks has been hampered by the lack of well-powered clinical trials where effects of such treatment are described in detail. Here, we aimed to provide a descriptive report on the largest cohort of severe pediatric asthma patients treated with terbutaline.
  
  
  METHODS
  The study was conducted in a pediatric intensive care unit in a large metropolitan tertiary care university hospital on 124 patients receiving terbutaline infusion. To stratify the effect of, and determine any age-related differences of, terbutaline, the patients were divided into 3 age groups (0-6 years, 7-12 years, and 13-18 years). Clinical response and the potential harmful effects of terbutaline infusion were determined.
  
  
  RESULTS
  There were significant reductions in systolic (varying between 86% and 93% of the baseline) and diastolic blood pressures (varying between 74% and 86% of the baseline level). However, the values returned to baseline level shortly after discontinuation of infusion. Terbutaline increased heart rates in all groups shortly after initiation (9%-13% above baseline), which returned to below baseline levels 1 hour after discontinuation. Serum potassium levels were also reduced in all patients compared to their baseline values after initiation of terbutaline infusion. However, none of the subjects required potassium replacement.
  
  
  CONCLUSIONS
  The results indicate that overall, terbutaline infusion was well tolerated without irreversible adverse effects of the treatment. Although hemodynamic and metabolic disturbances occurred, these were clinically easily managed and posed little risk in emergency department or pediatric intensive care unit.
authors.affiliation: From the Division of Pediatric Critical Care Medicine, Cohen Children's Medical Center of New York, New Hyde Park, NY.
authors.forename: Sule
authors.initials: S
authors.lastname: Doymaz
authors.forename: James
authors.initials: J
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000188:drug therapy*; D001794:Blood Pressure / Q000187:drug effects; D001993:Bronchodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D015278:Intensive Care Units, Pediatric; D008297:Male; D011188:Potassium / Q000097:blood; D012189:Retrospective Studies; D013726:Terbutaline / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D013726:Terbutaline; D011188:Potassium