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

Background: Patients with asthma may develop acute attack due to different types of triggering factors. Early recognition of an acut e asthma exacerbation is crucial for effective management. Objectives: To evaluate the effects of salbutamol nebulizer ve rsus salbutamol plus ipratropium bromide nebulizer in children with acut e asthma exacerbation attack. Patients and methods: A randomized double blind standard control clinica l study was conducted in Karbala Teaching Hospital for Chil dren from 1st of November 2015 to the end of November 2016 on patients presen t d to the emergency room (ER) of the Hospital. The study was conducted on hu dred patients presented with mild to moderate acute attacks of asthma, assigned to take either nebulized salbutamol or combination of salbutamol plus ipratr opium bromide during their stay. Assessment of asthma severity was done for ea ch p tient according to pulmonary index score (PIS) Results: There was significant reduction (p <0.05) in PIS fo r patients treated with salbutamol alone and patients treated with combinat io therapy (ipratropium + salbutamol) after 30,60 and 90 minutes from ER admi ssion as compare with their scores at baseline, 30 and 60 minutes respectively. After 30 minutes from ER admission, patients who were treated with combinati o 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 Kerbala Journal of Pharmaceutical Sciences. No. (15) 2018 (15) ددعلا ةينلاديصلا مولعلل ءلابرك ةلجم 123 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 moder at acute exacerbation attack with combination therapy of (ip ratropium plus salbutamol nebulizer) improved the clinical condition, lowered pulmonary index score, and significantly shortened the duration of stay in eme rgency room as compared with salbutamol nebulizer alone. Key wards: Ipratropium Bromide, Salbutamol, Childhood asthma, Acute Asthma Exacerbation يثأت ةنراقم ر لوماتويبلاسلا ريخبت م ع جيزم ريخبتريثأت ) يبورتاربلاا و م ديامورب و (لوماتويبلاسلا يف ع ةبونب نيباصملا لافطلأا جلا ةداحلا وبرلا ةيفلخلا : كمملا نم وبرلاب نوباصملا ىضرملا ن وضرعتي نا ا .تازفحملا نم ةفلتخم عاونأ ببسب ةداح ةبونل فرعتلا نا لاعف جلاعل مهم رما وه داحلا وبرلا مقافت ىلع ركبملا . فدهلا : ويبلاسلا ءاود ريخبت ريثأت ةنراقمل ريثأت لباقم لومات ريخبت جيزم مايبورتاربلاا) و (لوماتويبلاسلا ا يف لافطلأ وبرلا مقافت ةبونب نيباصملا لا .ةداح ةقيرط لمعلا : ضيرملاو ثحابلا نم لكل ةلوهجم هيريرس ةسارد تيرجا ةظفاحم يف لافطلأل يميلعتلا ءلابرك ىفشتسم يف يناثلا نيرشت نم لولاا نم ةرتفلل ءلابرك ٢٠١٥ يناثلا نيرشت رهش نم نوثلاثلا ةياغل ٢٠١٦ ىضرملل ةداحلا وبرلا مقافت ةبون عم ئراوطلا ةدحول نيعجارملا . ىلا مهميسقت متو ضيرم ةئم ىلع تيرجأ ةساردلا م نوسمخ مهددع غلابلا ىلولاا ةعومجملا يف ىضرملا ،نيتعومجم زملا ءاودلا اوذخا ضير جي ) مايبورتاربلااريخبت و هدحول لوماتويبلاسلا ءاود اوذخا ةيناثلا ةعومجملا يف ىضرملا اما (لوماتويبلاسلا . متو رشؤملا قفو ةبونلا ةدش مييقت يوئرلا يمييقتلا ) PIS ( قفو ضيرملل ةيريرسلا ةلاحلا ىلع دمتعي يذلاو