A Comparative Study of Salbutamol Nebulizer versus Ipratropium Bromide plus Salbutamol Nebulizer in the Treatment of Children with Acute Asthma Exacerbation

Abstract

Background: Patients with asthma may develop acute attack due to different typesof triggering factors. Early recognition of an acute asthma exacerbation is crucialfor effective management.Objectives: To evaluate the effects of salbutamol nebulizer versus salbutamol plusipratropium bromide nebulizer in children with acute asthma exacerbation attack.Patients and methods: A randomized double blind standard control clinical studywas conducted in Karbala Teaching Hospital for Children from 1st of November2015 to the end of November 2016 on patients presented to the emergency room(ER) of the Hospital. The study was conducted on hundred patients presented withmild to moderate acute attacks of asthma, assigned to take either nebulizedsalbutamol or combination of salbutamol plus ipratropium bromide during theirstay. Assessment of asthma severity was done for each patient according topulmonary index score (PIS)Results: There was significant reduction (p <0.05) in PIS for patients treated withsalbutamol alone and patients treated with combination therapy (ipratropium +salbutamol) after 30,60 and 90 minutes from ER admission as compare with theirscores at baseline, 30 and 60 minutes respectively. After 30 minutes from ERadmission, patients who were treated with combination of ipratropium bromide +salbutamol had significantly (p <0.05) lower PIS (5.60±2.77) than those treatedwith salbutamol alone (PIS=7.32±2.18). The mean duration of stay in ER was significantly (p <0.05) shorter in patient treated with combination therapy(57.60±21.71 min) than those with salbutamol alone (77.40±16.13 min).Conclusion: Treatment of asthmatic children with mild to moderate acuteexacerbation attack with combination therapy of (ipratropium plus salbutamolnebulizer) improved the clinical condition, lowered pulmonary index score, andsignificantly shortened the duration of stay in emergency room as compared withsalbutamol nebulizer alone.