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How long should Atrovent be given in acute asthma?
1Department of Thoracic Medicine, Castle Hill Hospital, East Yorkshire, UK.
Thorax
|August 26, 1998
Summary
Continuing nebulized ipratropium bromide and salbutamol therapy beyond 12 hours in acute asthma patients significantly improved recovery times. Extended treatment up to 36 hours aided patient discharge, suggesting lung function tests may not capture full treatment benefits.
Area of Science:
- Pulmonology
- Critical Care Medicine
- Pharmacology
Background:
- Optimal duration for combination nebulized therapy in acute asthma remains unclear.
- Previous studies primarily focused on single doses or short treatment durations (up to 12 hours).
- Investigating extended ipratropium bromide treatment is crucial for understanding its impact on recovery.
Purpose of the Study:
- To determine if extending the duration of nebulized ipratropium bromide treatment beyond 12 hours improves recovery in acute asthma patients.
- To compare the efficacy of continuing ipratropium bromide for 36 or 60 hours versus stopping at 12 hours.
Main Methods:
- A double-blind, randomized, placebo-controlled study involving 106 acute asthma patients.
- Patients received nebulized ipratropium bromide and salbutamol, systemic steroids, and theophylline if needed.
- Three groups: ipratropium stopped at 12 hours (Group I), 36 hours (Group II), or continued for 60 hours (Group III).
Main Results:
- No significant differences in peak expiratory flow rate (PEFR) or forced expiratory volume in one second (FEV1) were observed between groups at various time points.
- Median time to discharge was significantly longer in Group I (5.4 days) compared to Group II (4.1 days) and Group III (4.0 days).
Conclusions:
- Nebulized combination therapy for acute asthma can be extended up to 36 hours post-admission with beneficial effects on recovery time.
- Lung function tests alone may not fully indicate the therapeutic advantages of extended treatment durations.