Titre du document / Document title

How long should Atrovent be given in acute asthma?

Auteur(s) / Author(s)

BROPHY C. ⁽¹⁾ ; AHMED B. ⁽²⁾ ; BAYSTON S. ⁽¹⁾ ; ARNOLD A. ⁽¹⁾ ; MCGIVERN D. ⁽¹⁾ ; GREENSTONE M. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Thoracic Medicine, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, ROYAUME-UNI
⁽²⁾ Department of Medicine, Highland Hospital of Rochester, 1000 South Ave., Rochester, NY 14620, ETATS-UNIS

Résumé / Abstract

Background-In acute asthma the optimal duration of treatment with combination β agonist and anticholinergic nebuliser solutions is unknown; most studies have investigated single doses or treatment for up to 12 hours. To determine whether longer treatment with ipratropium bromide might aid recovery a study was undertaken in 106 patients with acute asthma. Methods-A double blind, randomised, placebo controlled, three group study was performed with all patients receiving ipratropium for 12 hours and salbutamol for 60 hours after admission (both nebulised four hourly), systemic steroids and, if necessary, theophylline. At 12 hours ipratropium was stopped in group I (n = 35) but was continued in the other two groups, and at 36 hours ipratropium was also stopped in group II (n = 35) while patients in group III (n = 36) continued with ipratropium for 60 hours. Spirometric tests were performed before and after salbutamol, and again 30 and 60 minutes after ipratropium or placebo at 12, 36 and 60 hours. Peak flow rates (PEFR) were measured before and after each nebulisation. Results-There were no differences between the groups in PEFR on admission (group I: 214 1/min, group II: 198 1/min, group III: 221 1/min), or mean forced expiratory volume in one second (FEV₁) at 12 hours (group I: 1.81, group II: 2.0 1, group III: 2.2 1), 36 hours (group I: 2.1 1, group II: 2.3 1, group III: 2.4 1), or at 60 hours (group I: 2.2 1, group II: 2.3 1, group III 2.5 1). Despite this, median time to discharge was significantly higher for patients in group I (5.4 days) than for those in groups II (4.1 days) and III (4.0 days). Conclusions-Combination nebulised therapy can be continued beyond 12 hours and up to 36 hours after admission with improved recovery time. Lung function testing may not reflect the full benefit of treatment.

Revue / Journal Title

Thorax   ISSN 0040-6376   CODEN THORA7 

Source / Source

1998, vol. 53, n^o5, pp. 363-367 (12 ref.)

Langue / Language

Anglais

Editeur / Publisher

BMJ, London, ROYAUME-UNI  (1946) (Revue)

Mots-clés anglais / English Keywords

Asthma ; Crisis ; Ipratropium bromide ; Chemotherapy ; Bronchodilator ; Lung function ; Treatment ; Exploration ; Human ; Respiratory disease ; Obstructive pulmonary disease ;

Mots-clés français / French Keywords

Asthme ; Crise ; Bromure d'ipratropium ; Chimiothérapie ; Bronchodilatateur ; Fonction respiratoire ; Traitement ; Exploration ; Homme ; Appareil respiratoire pathologie ; Bronchopneumopathie obstructive ;

Mots-clés espagnols / Spanish Keywords

Asma ; Crisis ; Bromuro de ipratropio ; Quimioterapia ; Broncodilatador ; Función respiratoria ; Tratamiento ; Exploración ; Hombre ; Aparato respiratorio patología ; Broncopneumopatía obstructiva ;

Localisation / Location

INIST-CNRS, Cote INIST : 7791, 35400007563282.0100