Efficacy of salbutamol-ipratropium bromide nebulization compared to salbutamol alone in children with mild to moderate asthma attacks
Abstract
Background The efficacy of salbutamol-ipratropiumbromide
nebulization in children with moderate asthma attacks remains
unclear, and studies on patients with mild attacks have been
relatively few, especially in Indonesia. However, it is common
practice for this drug combination to be given to patients with
mildô€“moderate asthma attacks.
Objective To compare the efficacy of salbutamolô€“ipratropium
bromide nebulization to salbutamol alone in children v.ith mild
to moderate asthma attacks.
Methods This single-blind, randomized clinical trial was held
in the Department of Child Health at Cipto Mangunkusumo
Hospital, the Tebet Community Health Center, and the MH
Thamrin Salemba Hospital on children aged 5ô€“18 years with
mild to moderate asthma attack. We randomized subjects
to receive either 2.5 mg salbutamol plus 0.5 mg ipratropium
bromide (experimental group) or 2.5 mg salbutamol alone
(control group). Nebulization was given twice, with a 20
minute interval between treatments. We assessed clinical
scores, vital signs, oxygen saturations, and peak flow rates
(PFRs) at baseline, and every 20 minutes up to 120 minutes
post-nebulization .
Results A total of 46 patients were randomized to either the
experimental or the control group. Subjects had similar baseline
measurements. At 20 minutes postô€“nebulization, the percentage
increase of PFR was 19% higher in the experimental group
(pô€€½O.OI, 95% CI 1.8 to 47.2). The proportion of PFR reversibility
was 27% higher in the experimental group, although this result
was statistically insignificant (P=0.06, 95% CI 0.03 to 0.52).
There were no significant differences in clinical scores, oxygen
saturations, respiratory rates, or hospitalization rates between the
two groups. Side effects also did not differ significantly.
Concl usion Salbutamolô€“ipratropium bromide nebulization
improved PFR measurements better than salbutamol alone.
However, other clinical parameters were not significantly different
between the two groups. [paediatr lndones. 2012;52:200,8].
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Accepted 2016-08-31
Published 2012-08-31
