Efficacy and safety of continuous albuterol nebulization in children with severe status asthmaticus.

We prospectively examined the efficacy and safety of continuous albuterol nebulization (CAN) therapy for children diagnosed with impending respiratory failure and status asthmaticus. Serum creatine phosphokinase (CPK) levels were measured, and other factors associated with cardiotoxicity were monitored. Seventeen patients (20 months to 17 years old) were enrolled in the study. No chest pain, arrhythmias, or signs of clinical deterioration occurred in any patient receiving CAN. No study subject required therapy with isoproterenol or mechanical ventilation. An elevation of total serum CPK was found in three patients; however, only one of these patients had an elevated (positive) CPK-MB isoenzyme fraction. We feel that CAN is safe for use in children diagnosed with status asthmaticus. Monitoring of serum CPK enzymes during CAN therapy is warranted until further studies have determined the significance of elevated CPK-MB isoenzymes in otherwise asymptomatic children treated for severe status asthmaticus.