In this study, we test whether there is a dose related relationship between inhaled albuterol therapy and metabolic acidosis.
Retrospective analysis of historical, demographic and physiologic data of all pediatric patients ( < 18yrs) admitted to pediatric intensive care unit (PICU) with diagnosis of severe acute asthma between Jan 1st 2007 and Dec 31st, 2008.
201 patients with asthma were admitted to the PICU during the study period. 42 patients (median age 7+/−2.67, 76.2 % male) had blood gases done during the admission and were included in the analysis. 30 patients (71.4%) were on high dose ( > 10 mg/h) continuous inhaled albuterol. There was no difference between age, gender, duration of symptoms before presentation, pediatric risk of mortality score between patient on high dose and low dose ( < 10 mg/h) albuterol. Heart rate and respiratory rate was higher in patients on high dose albuterol (159+/−2.1 vs 132+/−4.3, p = 0.04 and 41+/−5.4 vs 32+/−8.6, p = 0.05). 14 patients (33%) developed metabolic acidosis. 13 (43.3 %) of the patients on high dose albuterol compared to 1 (8.3%) of the low dose inhaled albuterol patients developed metabolic acidosis (p = 0.03).
High dose inhaled albuterol use is associated with metabolic acidosis in patients with severe acute asthma.
Hyperventilation in treated asthma may be a sign of metabolic acidosis which should be treated with a taper of albulerol therapy.
Saleha Chaudhry, No Financial Disclosure Information; No Product/Research Disclosure Information