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Low-dose l-isoproterenol versus salbutamol in hospitalized pediatric patients with severe acute exacerbation of asthma: A double-blind, randomized controlled trial

Authors :
Toshio Katsunuma
Takao Fujisawa
Takanobu Maekawa
Kenichi Akashi
Yukihiro Ohya
Yuichi Adachi
Koji Hashimoto
Mihoko Mizuno
Takanori Imai
Mari S. Oba
Mayumi Sako
Yasuo Ohashi
Hidefumi Nakamura
Source :
Allergology International, Vol 68, Iss 3, Pp 335-341 (2019)
Publication Year :
2019
Publisher :
Elsevier, 2019.

Abstract

Background: Although the guidelines in most countries do not recommend continuous inhalation of l-isoproterenol to treat pediatric patients with acute severe exacerbation of asthma, lower dose of l-isoproterenol has been widely used in Japan. To determine whether the efficacy of low-dose l-isoproterenol was superior to that of salbutamol, we conducted a double-blind, randomized controlled trial. Methods: Hospitalized patients aged 1–17 years were eligible if they had severe asthma exacerbation defined by the modified pulmonary index score (MPIS). Patients were randomly assigned (1:1) to receive inhalation of l-isoproterenol (10 μg/kg/h) or salbutamol (500 μg/kg/h) for 12 hours via a large-volume nebulizer with oxygen. The primary outcome was the change in MPIS from baseline to 3 hours after starting inhalation. Trial registration number UMIN000001991. Results: From December 2009 to October 2013, 83 patients (42 in the l-isoproterenol group and 41 in the salbutamol group) were enrolled into the study. Of these, one patient in the l-isoproterenol group did not receive the study drug and was excluded from the analysis. Compared with salbutamol, l-isoproterenol reduced MPIS more rapidly. Mean (SD) changes in MPIS at 3 hours were −2.9 (2.5) in the l-isoproterenol group and −0.9 (2.3) in the salbutamol group (difference −2.0, 95% confidence interval −3.1 to −0.9; P

Details

Language :
English
ISSN :
13238930
Volume :
68
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Allergology International
Publication Type :
Academic Journal
Accession number :
edsdoj.4c1c96d42cf94f339e7435c73e674d01
Document Type :
article
Full Text :
https://doi.org/10.1016/j.alit.2019.02.001