Metered-dose inhaler ipratropium bromide for children with acute asthma exacerbation: A prospective, non-randomized, observational study
| Autor: | Osamu Nomura, Nobuaki Inoue, Akira Akasawa, Hiroshi Sakakibara, Yusuke Hagiwara, Takateru Ihara, Yoshihiko Morikawa |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Exacerbation Ipratropium bromide Internal medicine Administration Inhalation medicine Humans Metered Dose Inhalers Prospective Studies Child Propensity Score Inhalation business.industry Inhaler Ipratropium Emergency department Metered-dose inhaler Asthma Bronchodilator Agents Hospitalization Child Preschool Pediatrics Perinatology and Child Health Propensity score matching Vomiting Female medicine.symptom business Emergency Service Hospital medicine.drug |
| Zdroj: | Pediatrics international : official journal of the Japan Pediatric SocietyReferences. 62(3) |
| ISSN: | 1442-200X |
| Popis: | Background Ipratropium bromide (IB), when administered with β2-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. |
| Databáze: | OpenAIRE |
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