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Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma.
J Pediatr. 2001 Jan; 138(1):51-58.JPed

Abstract

OBJECTIVE

To determine whether the addition of repeated doses of nebulized ipratropium bromide (IB) to a standardized inpatient asthma care algorithm (ACA) for children with status asthmaticus improves clinical outcome.

STUDY DESIGN

Children with acute asthma (N = 210) age 1 to 18 years admitted to the ACA were assigned to the intervention or placebo group in randomized double-blind fashion. Both groups received nebulized albuterol, systemic corticosteroids, and oxygen according to the ACA. The intervention group received 250 microg IB combined with 2.5 mg albuterol by jet nebulization in a dosing schedule determined by the ACA phase. The placebo group received isotonic saline solution substituted for IB. Progression through each ACA phase occurred based on assessments of oxygenation, air exchange, wheezing, accessory muscle use, and respiratory rate performed at prescribed intervals.

RESULTS

No significant differences were observed between treatment groups in hospital length of stay (P =.46), asthma carepath progression (P =.37), requirement for additional therapy, or adverse effects. Children >6 years (N = 70) treated with IB had shorter mean hospital length of stay (P =.03) and more rapid mean asthma carepath progression (P =.02) than children in the placebo group. However, after adjustment was done for baseline group differences, the observed benefit of IB therapy in older children no longer reached statistical significance.

CONCLUSION

The routine addition of repeated doses of nebulized IB to a standardized regimen of systemic corticosteroids and frequently administered beta-2 agonists confers no significant enhancement of clinical outcome for the treatment of hospitalized children with status asthmaticus.

Authors+Show Affiliations

Division of Pediatric Pulmonology, Department of Pediatrics, University Hospitals of Cleveland, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, Ohio 44106, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

11148512

Citation

Craven, D, et al. "Ipratropium Bromide Plus Nebulized Albuterol for the Treatment of Hospitalized Children With Acute Asthma." The Journal of Pediatrics, vol. 138, no. 1, 2001, pp. 51-58.
Craven D, Kercsmar CM, Myers TR, et al. Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma. J Pediatr. 2001;138(1):51-58.
Craven, D., Kercsmar, C. M., Myers, T. R., O'riordan, M. A., Golonka, G., & Moore, S. (2001). Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma. The Journal of Pediatrics, 138(1), 51-58.
Craven D, et al. Ipratropium Bromide Plus Nebulized Albuterol for the Treatment of Hospitalized Children With Acute Asthma. J Pediatr. 2001;138(1):51-58. PubMed PMID: 11148512.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ipratropium bromide plus nebulized albuterol for the treatment of hospitalized children with acute asthma. AU - Craven,D, AU - Kercsmar,C M, AU - Myers,T R, AU - O'riordan,M A, AU - Golonka,G, AU - Moore,S, PY - 2001/1/10/pubmed PY - 2001/3/10/medline PY - 2001/1/10/entrez SP - 51 EP - 58 JF - The Journal of pediatrics JO - J. Pediatr. VL - 138 IS - 1 N2 - OBJECTIVE: To determine whether the addition of repeated doses of nebulized ipratropium bromide (IB) to a standardized inpatient asthma care algorithm (ACA) for children with status asthmaticus improves clinical outcome. STUDY DESIGN: Children with acute asthma (N = 210) age 1 to 18 years admitted to the ACA were assigned to the intervention or placebo group in randomized double-blind fashion. Both groups received nebulized albuterol, systemic corticosteroids, and oxygen according to the ACA. The intervention group received 250 microg IB combined with 2.5 mg albuterol by jet nebulization in a dosing schedule determined by the ACA phase. The placebo group received isotonic saline solution substituted for IB. Progression through each ACA phase occurred based on assessments of oxygenation, air exchange, wheezing, accessory muscle use, and respiratory rate performed at prescribed intervals. RESULTS: No significant differences were observed between treatment groups in hospital length of stay (P =.46), asthma carepath progression (P =.37), requirement for additional therapy, or adverse effects. Children >6 years (N = 70) treated with IB had shorter mean hospital length of stay (P =.03) and more rapid mean asthma carepath progression (P =.02) than children in the placebo group. However, after adjustment was done for baseline group differences, the observed benefit of IB therapy in older children no longer reached statistical significance. CONCLUSION: The routine addition of repeated doses of nebulized IB to a standardized regimen of systemic corticosteroids and frequently administered beta-2 agonists confers no significant enhancement of clinical outcome for the treatment of hospitalized children with status asthmaticus. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/11148512/Ipratropium_bromide_plus_nebulized_albuterol_for_the_treatment_of_hospitalized_children_with_acute_asthma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(01)51244-5 DB - PRIME DP - Unbound Medicine ER -