{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T03:53:38Z","timestamp":1784865218666,"version":"3.55.0"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T00:00:00Z","timestamp":1680912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Inhaled selective short-acting \u03b2-2 agonists (SABA), such as salbutamol, are the rescue treatment of choice for the relief of symptoms of acute asthma exacerbations: one of the leading causes of pediatric emergency department admission and hospitalization. Cardiovascular events, including supraventricular arrhythmias, are the most frequent side effects reported with inhaled SABA in children with asthma and are the main reason for a continuing debate about their safety, despite their widespread use. Although supraventricular tachycardia (SVT) is the most common potentially serious dysrhythmia in children, the incidence and risk factor of SVT after SABA administration is currently unknown. We here reported three cases and conducted a review of the literature in an attempt to gain insight into this issue.<\/jats:p>","DOI":"10.3390\/children10040699","type":"journal-article","created":{"date-parts":[[2023,4,10]],"date-time":"2023-04-10T03:49:29Z","timestamp":1681098569000},"page":"699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Inhaled Short-Acting Beta Agonist Treatment-Associated Supraventricular Tachycardia in Children: Still a Matter of Concern in Pediatric Emergency Departments?"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-738X","authenticated-orcid":false,"given":"Bertrand","family":"Tchana","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Division, Parma General and University Hospital, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7710-6995","authenticated-orcid":false,"given":"Carlo","family":"Caffarelli","sequence":"additional","affiliation":[{"name":"Clinica Pediatrica, Azienda Ospedaliero-Universitaria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,8]]},"reference":[{"key":"ref_1","unstructured":"Roemer, M. (2011). Health Care Expenditures for the Five Most Common Children\u2019s Conditions, 2008: Estimates for U.S. Civilian Noninstitutionalized Children, Ages 0-17."},{"key":"ref_2","unstructured":"National Asthma Education and Prevention Program (2007). Guidelines for the Diagnosis and Management of Asthma."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/s13052-018-0481-1","article-title":"Italian Panel for the management of acute asthma attack in children Roberto Bernardini. Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics","volume":"44","author":"Indinnimeo","year":"2018","journal-title":"Ital. J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4","DOI":"10.12974\/2311-8687.2013.01.01.2","article-title":"Safety and potential side effects of beta 2-agonists: A still debated question","volume":"1","author":"Bozzola","year":"2013","journal-title":"Int. J. Pediatr. Child Health"},{"key":"ref_5","unstructured":"Garson, A., Bricker, J.T., Fisher, D.J., and Neish, S.R. (1998). Science and Practice of Pediatric Cardiology, Williams and Wilkins. [2nd ed.]."},{"key":"ref_6","first-page":"167","article-title":"Paroxysmal tachycardia in infants and children; study of 41 cases","volume":"9","author":"Nadas","year":"1952","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0002-8703(81)80015-4","article-title":"Electrophysiologic studies of supraventricular tachycardia in children. I. Clinical-electrophysiologic correlations","volume":"102","author":"Garson","year":"1981","journal-title":"Am. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0196-0644(99)70392-6","article-title":"Adenosine and pediatric supraventricular tachycardia in the emergency department: Multicenter study and review","volume":"33","author":"Losek","year":"1999","journal-title":"Ann. Emerg. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1111\/j.1651-2227.2008.00823.x","article-title":"Neonatal supraventricular tachycardia: Outcomes over a 27-year period at a single institution","volume":"97","author":"Gilljam","year":"2008","journal-title":"Acta Paediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1016\/j.amjcard.2013.05.035","article-title":"Natural history of Wolff-Parkinson-White syndrome diagnosed in childhood","volume":"112","author":"Cain","year":"2013","journal-title":"Am. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100","DOI":"10.2174\/1874306400903010100","article-title":"Safety of daily albuterol in infants with a history of bronchospasm: A multi-center placebo-controlled trial","volume":"3","author":"Hedrick","year":"2009","journal-title":"Open Respir. Med. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/0140-6736(90)93099-B","article-title":"Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma","volume":"336","author":"Wong","year":"1990","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1136\/pgmj.66.772.98","article-title":"The cardiovascular effects of beta-adrenergic agonist drugs administered by nebulisation","volume":"66","author":"Flatt","year":"1990","journal-title":"Postgrad. Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2057","DOI":"10.1378\/chest.127.6.2057","article-title":"Acute electrophysiologic effects of inhaled salbutamol in humans","volume":"127","author":"Kallergis","year":"2005","journal-title":"Chest"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/S0196-0644(94)70146-6","article-title":"Adenosine in the termination of albuterol-induced supraventricular tachycardia","volume":"24","author":"Cook","year":"1994","journal-title":"Ann. Emerg. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1097\/00006565-199504000-00010","article-title":"Supraventricular tachycardia: A complication of nebulized albuterol","volume":"11","author":"Keller","year":"1995","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/000992280003901109","article-title":"Recurrent supraventricular tachycardia as a complication of nebulized albuterol treatment","volume":"39","author":"Duane","year":"2000","journal-title":"Clin. Pediatr."},{"key":"ref_18","first-page":"93","article-title":"Probable association of tachyarrhythmia with nebulized albuterol in a child with previously subclinical Wolff Parkinson White syndrome","volume":"17","author":"Kroesen","year":"2012","journal-title":"J. Pediatr. Pharmacol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1080\/02770903.2019.1709867","article-title":"Incidence of supraventricular tachycardia after inhaled short-acting beta agonist treatment in children","volume":"58","author":"Woodward","year":"2021","journal-title":"J. Asthma"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Leung, J.S., Johnson, D.W., Sperou, A.J., Crotts, J., Saude, E., Hartling, L., and Stang, A. (2017). A systematic review of adverse drug events associated with administration of common asthma medications in children. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0182738"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.2165\/00003495-200565120-00001","article-title":"Inhaled beta2-adrenoceptor agonists: Cardiovascular safety in patients with obstructive lung disease","volume":"65","author":"Cazzola","year":"2005","journal-title":"Drugs"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1136\/bmj.288.6414.367","article-title":"Incidence of cardiac arrhythmias in patients taking slow-release salbutamol and slow release terbutaline for asthma","volume":"288","author":"Hayward","year":"1984","journal-title":"Br. Med. J. (Clin. Res. Ed.)"},{"key":"ref_23","first-page":"203","article-title":"Beta 1- and beta 2-adrenoceptors in the human heart: Properties, function, and alterations in chronic heart failure","volume":"43","author":"Brodde","year":"1991","journal-title":"Pharmacol. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1161\/01.RES.85.11.1092","article-title":"Recent advances in cardiac beta (2)-adrenergic signal transduction","volume":"85","author":"Xiao","year":"1999","journal-title":"Circ. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1111\/j.1540-8167.1996.tb00479.x","article-title":"Beta-adrenergic and muscarinic cholinergic receptor densities in the human sinoatrial node: Identification of a high beta 2-adrenergic receptor density","volume":"7","author":"Rodefeld","year":"1996","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1592\/phco.31.8.748","article-title":"Effects of an inhaled \u03b22-agonist on cardiovascular function and sympathetic activity in healthy subjects","volume":"31","author":"Snyder","year":"2011","journal-title":"Pharmacotherapy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/PEC.0b013e3181d1e40d","article-title":"Repeat dosing of albuterol via metered-dose inhaler in infants with acute obstructive airway disease: A randomized controlled safety trial","volume":"26","author":"Kaashmiri","year":"2010","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1161\/01.CIR.94.3.353","article-title":"Acute effects of \u03b21-selective and nonselective \u03b2-adrenergic receptor blockade on cardiac sympathetic activity in congestive heart failure","volume":"94","author":"Newton","year":"1996","journal-title":"Circulation"},{"key":"ref_29","first-page":"651","article-title":"Adrenergic and muscarinic receptors in the human heart","volume":"51","author":"Brodde","year":"1999","journal-title":"Pharmacol. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1111\/acem.12997","article-title":"Diastolic Hypotension, Troponin Elevation, and Electrocardiographic Changes Associated with the Management of Moderate to Severe Asthma in Children","volume":"23","author":"Fagbuyi","year":"2016","journal-title":"Acad. Emerg. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1136\/thx.44.2.136","article-title":"Cardiovascular and hypokalaemic effects of inhaled salbutamol, fenoterol, and isoprenaline","volume":"44","author":"Crane","year":"1989","journal-title":"Thorax"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e273","DOI":"10.1097\/PCC.0b013e31828a7677","article-title":"Diastolic hypotension is an unrecognized risk factor for \u03b2-agonist-associated myocardial injury in children with asthma","volume":"14","author":"Sarnaik","year":"2013","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"693","DOI":"10.3109\/02770903.2014.1002566","article-title":"Diastolic hypotension in pediatric patients with asthma receiving continuous albuterol","volume":"52","author":"Wisecup","year":"2015","journal-title":"J. Asthma"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/00063110-200309000-00012","article-title":"The administration of beta2-agonists for paediatric asthma and its adverse reaction in Australian and New Zealand emergency departments: A cross-sectional survey","volume":"10","author":"Habashy","year":"2003","journal-title":"Eur. J. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1067\/mai.2001.120134","article-title":"Levalbuterol Pediatric Study Group. Low dose levalbuterol in children with asthma: Safety and efficacy in comparison with placebo and racemic albuterol","volume":"108","author":"Milgrom","year":"2001","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1111\/j.1476-5381.1994.tb14025.x","article-title":"The dose-related hyper-and-hypokalaemic effects of salbutamol and its arrhythmogenic potential","volume":"111","author":"Hay","year":"1994","journal-title":"Br. J. Pharmacol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1002\/ppul.20288","article-title":"Evaluation of the safety and efficacy of levalbuterol in 2-5-year-old patients with asthma","volume":"40","author":"Skoner","year":"2005","journal-title":"Pediatr. Pulmonol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/0002-9149(90)91351-6","article-title":"Effects of isoproterenol on accessory pathway conduction in intermittent or concealed Wolff-ParkinsonWhite syndrome","volume":"65","author":"Yamamoto","year":"1990","journal-title":"Am. J. Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1378\/chest.103.6.1892","article-title":"Repeated inhalation of nebulized albuterol did not induce arrhythmias in a patient with Wolff-Parkinson-White syndrome and asthma","volume":"103","author":"Bonnin","year":"1993","journal-title":"Chest"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1161\/01.RES.59.3.297","article-title":"Beta 1- and beta 2-adrenergic-receptor subpopulations in nonfailing and failing human ventricular myocardium: Coupling of both receptor subtypes to muscle contraction and selective beta 1-receptor down-regulation in heart failure","volume":"59","author":"Bristow","year":"1986","journal-title":"Circ. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.jaci.2005.11.012","article-title":"Molecular mechanisms of beta (2)-adrenergic receptor function, response, and regulation","volume":"117","author":"Johnson","year":"2006","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1159\/000341969","article-title":"Hydrogen peroxide in exhaled breath condensate in asthmatic children during acute exacerbation and after treatment","volume":"84","author":"Caffarelli","year":"2012","journal-title":"Respiration"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"51","DOI":"10.2500\/aap.2014.35.3740","article-title":"Airway acidification in childhood asthma exacerbations","volume":"35","author":"Caffarelli","year":"2014","journal-title":"Allergy Asthma Proc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.ijcard.2006.04.026","article-title":"The role of oxidative stress in the pathogenesis and perpetuation of atrial fibrillation","volume":"115","author":"Korantzopoulos","year":"2007","journal-title":"Int. J. Cardiol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/4\/699\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:12:39Z","timestamp":1760123559000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/10\/4\/699"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,8]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["children10040699"],"URL":"https:\/\/doi.org\/10.3390\/children10040699","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,8]]}}}