A Comparative Study of Salbutamol Nebulizer versus Ipratropium Bromide plus Salbutamol Nebulizer in the Treatment of Children with Acute Asthma Exacerbation
karbala journal of pharmaceutical sciences,
Volume 9, Issue 15, Pages 122-137
AbstractBackground: Patients with asthma may develop acute attack due to different types
of triggering factors. Early recognition of an acute asthma exacerbation is crucial
for effective management.
Objectives: To evaluate the effects of salbutamol nebulizer versus salbutamol plus
ipratropium bromide nebulizer in children with acute asthma exacerbation attack.
Patients and methods: A randomized double blind standard control clinical study
was conducted in Karbala Teaching Hospital for Children from 1st of November
2015 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 with
mild to moderate acute attacks of asthma, assigned to take either nebulized
salbutamol or combination of salbutamol plus ipratropium bromide during their
stay. Assessment of asthma severity was done for each patient according to
pulmonary index score (PIS)
Results: There was significant reduction (p <0.05) in PIS for patients treated with
salbutamol alone and patients treated with combination therapy (ipratropium +
salbutamol) after 30,60 and 90 minutes from ER admission as compare with their
scores at baseline, 30 and 60 minutes respectively. After 30 minutes from ER
admission, patients who were treated with combination of ipratropium bromide +
salbutamol had significantly (p <0.05) lower PIS (5.60±2.77) than those treated
with 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 acute
exacerbation attack with combination therapy of (ipratropium plus salbutamol
nebulizer) improved the clinical condition, lowered pulmonary index score, and
significantly shortened the duration of stay in emergency room as compared with
salbutamol nebulizer alone..
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