Abstract:
A 22-kg female in early childhood with a history of reactive airway disease presented to a paediatric emergency department with acute shortness of breath, tachypnoea and wheezing. Despite treatment with albuterol and corticosteroids, her bronchospasm persisted, prompting the administration of terbutaline. The patient received 220 mcg (10 mcg/kg) terbutaline intravenously, followed immediately by an inadvertent supratherapeutic intravenous dose of 10 000 mcg (454.5 mcg/kg). The patient\'s laboratory results obtained minutes after the medication error were notable for: potassium, 3.1 mmol/L, lactate, 2.6 mmol/L and troponin I, 0.30 ng/mL (normal <0.03 ng/mL). Over the next 48 hours, serial serum troponin values decreased. The patient was discharged home approximately 72 hours after the initial presentation and she remained well based on follow-up calls over the next several months. Given the timing and trend of troponin concentrations, we do not believe the terbutaline overdose to be responsible for the myocardial injury.
摘要:
一名22公斤重的幼年女性,有反应性气道疾病史,因急性呼吸急促而被送往儿科急诊科,呼吸急促和喘息.尽管用沙丁胺醇和皮质类固醇治疗,她的支气管痉挛持续存在,促使服用特布他林。患者静脉注射220mcg(10mcg/kg)特布他林,随后立即进行10000mcg(454.5mcg/kg)的静脉内治疗剂量。患者在用药错误后几分钟获得的实验室结果值得注意:钾,3.1mmol/L,乳酸,2.6mmol/L和肌钙蛋白I,0.30ng/mL(正常<0.03ng/mL)。在接下来的48小时里,连续血清肌钙蛋白值下降。患者在初次就诊后约72小时出院,并且在接下来的几个月中,根据随访电话,她仍然保持良好。考虑到肌钙蛋白浓度的时间和趋势,我们不认为特布他林过量是心肌损伤的原因。