Acute severe asthma attacks in children are life-threatening
emergencies. With appropriate and prompt treatment most children recover
uneventfully. When complications occur, they are usually a consequence of
disease progression and/or its treatment. Established cardiac complications
associated with acute asthma treatment in children include supraventricular
tachycardia (SVT) and acute coronary ischaemia.
More recently, two groups have
reported elevated cardiac troponin I (CTnI) levels in children treated foracute asthma. In this case series, the raised levels of CTnI were not generally
accompanied by overt symptoms or signs of coronary ischaemia. Following an
index case of a child with acute severe asthma who developed acute coronary
ischaemia in association with elevated CTnI levels and IV salbutamol therapy,
our local policy has been to screen/monitor patients on continuous IV
salbutamol for cardiac ischaemia using blood CTnI levels. Here, we report our
observations of CTnI levels in children treated with intravenous (IV)
salbutamol for acute severe asthma.
This is a retrospective audit of routine clinical practice.
The case mix comprises of children treated for acute severe asthma with IV
salbutamol at the Leicester Royal Infirmary between September 2012 and April
2013. All children with severe asthma are managed in adjoining high dependency
care or intensive care units. Patients with severe asthma were identified using
ward admission databases.
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