Metered-dose inhaler ipratropium bromide for children with acute asthma exacerbation: A prospective, non-randomized, observational study.
Pediatr Int
; 62(3): 319-323, 2020 Mar.
Article
em En
| MEDLINE
| ID: mdl-31930755
ABSTRACT
BACKGROUND:
Ipratropium bromide (IB), when administered with ß2-agonists, is effective in reducing hospital admissions of children presenting to the emergency department (ED) with severe asthma. While IB is commonly delivered in its nebulized form, using a metered-dose inhaler (MDI), can, reportedly, shorten patients' length of stay in the ED. However, the effectiveness and safety of IB administration using an MDI with a spacer have not been established. This study aimed to investigate the effectiveness and safety of MDI-delivered IB in pediatric patients with acute asthma exacerbation.METHODS:
This prospective, non-randomized, observational study included patients aged ≥4 years with a history of severe asthma exacerbation. Patients received IB via MDI with a spacer three times at 20-min intervals. IB use was determined by the physicians' treatment policy. Propensity score matching was used to adjust the confounding factors related to IB administration.RESULTS:
Of the 158 patients, 88 were treated with IB and 70 were treated without IB. A propensity score-matching analysis extracted 54 patients from each group. We found no statistical difference in the admission rate of the two groups (IB group 25.9% vs non-IB group 31.5%; P = 0.67). The post-treatment modified pulmonary index scores (mean ± SD) were also similar (IB 6.6 ± 2.0 vs non-IB 6.3 ± 2.5; P = 0.53). Only one patient (1.0%) treated with IB experienced vomiting, which resolved spontaneously.CONCLUSION:
The metered-dose inhaler IB was ineffective in reducing the admission rate possibly because it was less effective than a nebulizer for IB inhalation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Asma
/
Broncodilatadores
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Ipratrópio
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Inaladores Dosimetrados
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Child
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Child, preschool
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article