- 期刊
Evaluation of Different Nebulized Bronchoclilators on Clinical Efficacy and Hypokalemia in Asthmatic Children
氣喘兒童使用不同霧化氣管擴張劑之臨床效果
摘要
氣管擴張劑是治療氣喘之第一線藥物，而其霧化劑型更是使用方便，作用快速足以快速減少氣喘症狀，因此常被使用在小兒急診室來治療急性氣喘發作之病童。但由於兒科之病人之配合度較差，因此對於使用藥物之作用及副作用評估較困難。本研究針對三十位氣喘發作而至本院兒笠急診求診之病人，在不預設立場(randomized)下分成兩組，一組使用霧化salbutamol，一組使用霧化terbutaline，比較其作用及副作用後我們發現在治療三十分鍾後，在使用霧化salbutamol組的病人，不但臨床指標（包括呼吸速率，尖峰吐氣流量）有所改善，在抽血所測得之血中氣體分析，也獲得改善。而在使用霧化terbutaline治療之病人，只有在臨床指標獲得改善。但在血中氣體分析並有達到統計學意義之改善。但兩組病人都有產生達到紡計學意義之降低血鉀狀況。因此以三十分鍾之短暫效果而言，霧化salbutamol的效果會比霧化terbutaline為得好，但都會產生降低血鉀的狀況，使用時須注意有地無其他可能造成低血鉀的狀況。
並列摘要
Acute asthma attack continues to be a major cause for children admitted to the emergency room. Nebulized beta 2-adrenergic agonists are still the first-line drugs for a rapid bronchodilatation effect and an easily administered drug during acute asthma attack. The bronchodilator-induced hypokalemia is thought significant in adult group, but is often ignored in children group. In this study, we conducted a randomized study to compare the laboratory and clinical effects between nebulized salbutamol and terbutaline. We found that both salbutamol and terbutaline nebulization induced a significant hypokalemia (p＜0.05). Terbutaline nebulization also significantly improved the peak expiratory flow rate (PEFR) and respiratory rate (RR), but not venous partial pressure of oxygen (PvCO2), venous carbon dioxide tension (PvCO2) and O2 saturation in venous blood (SvO2). In contrast, salbutamol improved not only PEFR and RR, but also PvO2, PvCO2, and SvO2 30 minutes of administration. In conclusion, the nebulized salbutamol, although induced a hypokalemic effect which is similar to terbutaline group, has a better effect on improving O2, saturation than nebulized terbutaline with the same dose 30 minutes after administered for children with acute asthma attack.