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Inhaled salbutamol plus ipratropium in moderate and severe asthma crises in children

Ricardo Iramain1, Jesús López-Herce, Julia Coronel

  • 1Emergency Unit, Emergency Department, Maternity-Children's Hospital, Asunción National University Asunción, Paraguay.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|February 22, 2011
PubMed

Insights

Adding ipratropium bromide to salbutamol significantly improves lung function and reduces hospitalizations in children with asthma crises. This combination therapy is more effective in severe asthma cases.

Area of Science:

  • Pediatric Pulmonology
  • Emergency Medicine
  • Clinical Pharmacology

Background:

  • Inhaled bronchodilators are standard for acute pediatric asthma.
  • Evidence from randomized controlled trials (RCTs) for combined therapy is limited.
  • Current guidelines recommend combined inhaled beta(2) agonists and anticholinergics.

Purpose of the Study:

  • To evaluate the efficacy of salbutamol plus ipratropium bromide in pediatric asthma crises.
  • To assess improvements in oxygenation and lung function.
  • To determine the impact on hospitalization rates.

Main Methods:

  • Prospective, randomized, double-blind study design.
  • Inclusion of children aged 2-18 years with moderate to severe asthma crises.
  • Six nebulizations of salbutamol/placebo or salbutamol/ipratropium, with reassessment of clinical status and spirometry.

Main Results:

  • 97 children completed the study; 49 received salbutamol/ipratropium, 48 received salbutamol alone.
  • The salbutamol/ipratropium group showed greater improvement in clinical status and lung function.
  • Hospitalization rates were significantly lower in the combination group (18.4%) versus the salbutamol-only group (43.8%).

Conclusions:

  • Salbutamol plus ipratropium bromide enhances lung function in pediatric asthma crises.
  • The combination therapy significantly reduces hospitalization needs, particularly in severe cases.
  • Treatment efficacy is consistent across different age groups within the pediatric range.
Abstract

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