Faculty Opinions recommendation of Early administration of systemic corticosteroids reduces hospital admission rates for children with moderate and severe asthma exacerbation.

2012 ◽  
Author(s):  
Leonard Bacharier ◽  
Avraham Beigelman
Keyword(s):  
Hospital Admission ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Early Administration ◽  
Admission Rates ◽  
Systemic Corticosteroids ◽  
Severe Asthma Exacerbation

scholarly journals Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: a meta-analysis

2020 ◽  
Author(s):  
Hongzhen Xu ◽  
Lin Tong ◽  
Peng Gao ◽  
Yan Hu ◽  
Huijuan Wang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Admission ◽  
Children And Adolescents ◽  
Severe Asthma ◽  
Subgroup Analysis ◽  
Asthma Exacerbation ◽  
Ipratropium Bromide ◽  
Cochrane Library ◽  
Severe Asthma Exacerbation ◽  
Asthma In Children

AbstractBackgroundA combination of ipratropium bromide (IB) and salbutamol is commonly used to treat asthma in children and adolescents; however, there has been a lack of consistency in its usage in clinical practice.ObjectiveTo evaluate the efficacy and safety of IB + salbutamol in the treatment of asthma in children and adolescents.MethodsThe MEDLINE, Embase, and Cochrane Library as well as other Chinese biomedical databases (including China Biological Medicine Database, Chinese National Knowledge Infrastructure, Chongqing VIP, and Wanfang Chinese language bibliographic database) were systematically searched from the date of database inception to 02/09/2019 for randomized controlled trials in children and adolescents (≤18 years) with asthma who received IB + salbutamol or salbutamol alone. The primary outcomes included hospital admission and adverse events. A random effects model with a 95% confidence interval (CI) was used. Subgroup analysis was performed according to age, severity of asthma, and co-interventions with other asthma controllers. This study was registered with PROSPERO.ResultsOf the 637 studies that were identified, 55 met the inclusion criteria and involved 6396 participants. IB + salbutamol significantly reduced the risk of hospital admission compared with salbutamol alone (risk ratio [RR] 0.79; 95% CI 0.66–0.95; p = 0.01; I2 = 40%). Subgroup analysis only showed significant difference in the risk of hospital admission in participants with severe asthma exacerbation (RR 0.71; 95% CI 0.60–0.85; p = 0.0001; I2 = 0%) and moderate-to-severe exacerbation (RR 0.69; 95% CI 0.50–0.96; p = 0.03; I2 = 3%). There were no significant differences in the risk of adverse events between IB + salbutamol group and salbutamol alone group (RR 1.77; 95% CI 0.63–4.98).ConclusionIB + salbutamol may be more effective than salbutamol alone for the treatment of asthma in children and adolescents, especially in those with severe and moderate to severe asthma exacerbation. Future prospective research on these subgroup population are needed.

scholarly journals Combination of ipratropium bromide and salbutamol in children and adolescents with asthma: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0237620
Author(s):  
Hongzhen Xu ◽  
Lin Tong ◽  
Peng Gao ◽  
Yan Hu ◽  
Huijuan Wang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Admission ◽  
Children And Adolescents ◽  
Severe Asthma ◽  
Subgroup Analysis ◽  
Asthma Exacerbation ◽  
Ipratropium Bromide ◽  
Cochrane Library ◽  
Severe Asthma Exacerbation ◽  
Asthma In Children

Background A combination of ipratropium bromide (IB) and salbutamol is commonly used to treat asthma in children and adolescents; however, there has been a lack of consistency in its usage in clinical practice. Objective To evaluate the efficacy and safety of IB + salbutamol in the treatment of asthma in children and adolescents. Methods The MEDLINE, Embase, and Cochrane Library as well as other Chinese biomedical databases (including China Biological Medicine Database, Chinese National Knowledge Infrastructure, Chongqing VIP, and Wanfang Chinese language bibliographic database) were systematically searched from the earliest record date to September 2020 for randomized controlled trials in children and adolescents (≤18 years) with asthma who received IB + salbutamol or salbutamol alone. The primary outcomes included hospital admission and adverse events. A random effects model with a 95% confidence interval (CI) was used. Subgroup analysis was performed according to age, severity of asthma, and co-interventions with other asthma controllers. This study was registered with PROSPERO. Results Of the 1061 studies that were identified, 55 met the inclusion criteria and involved 6396 participants. IB + salbutamol significantly reduced the risk of hospital admission compared with salbutamol alone (risk ratio [RR] 0.79; 95% CI 0.66–0.95; p = 0.01; I2 = 40%). Subgroup analysis only showed significant difference in the risk of hospital admission in participants with severe asthma exacerbation (RR 0.73; 95% CI 0.60–0.88; p = 0.0009; I2 = 4%) and moderate-to-severe exacerbation (RR 0.69; 95% CI 0.50–0.96; p = 0.03; I2 = 3%). There were no significant differences in the risk of adverse events between IB + salbutamol group and salbutamol alone group (RR 1.77; 95% CI 0.63–4.98). Conclusion IB + salbutamol may be more effective than salbutamol alone for the treatment of asthma in children and adolescents, especially in those with severe and moderate to severe asthma exacerbation. The very low to high quality of evidence indicated that future well-designed double-blind RCTs with large sample are needed for research on evaluating the effectiveness of IB + salbutamol treatment for asthma in children and adolescents.

scholarly journals Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d’Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Philippe Le Conte ◽  
Nicolas Terzi ◽  
Guillaume Mortamet ◽  
Fekri Abroug ◽  
Guillaume Carteaux ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Intensive Care ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
Extensive Literature ◽  
Level Of Evidence ◽  
Severe Asthma Exacerbation ◽  
Evidence Grade

Abstract Background The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients. Results The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology. An extensive literature research was conducted based on publications indexed in PubMed™ and Cochrane™ databases. Of the 21 formalized guidelines, 4 had a high level of evidence (GRADE 1+/−) and 7 a low level of evidence (GRADE 2+/−). The GRADE method was inapplicable to 10 guidelines, which resulted in expert opinions. A strong agreement was reached for all guidelines. Conclusion The conjunct work of 36 experts from 3 scientific societies resulted in 21 formalized recommendations to help improving the emergency and intensive care management of adult and pediatric patients with SAE.

Emergency Management of Acute Severe Asthma Exacerbation in the Adult Population

2010 ◽  
Vol 1 (5) ◽  
pp. 174-179
Author(s):  
Sandra E. Marotta ◽  
Yuly Belchikov ◽  
Katherine Banker ◽  
Peter S. Marshall
Keyword(s):  
Emergency Management ◽  
Severe Asthma ◽  
Asthma Exacerbation ◽  
Adult Population ◽  
Acute Severe Asthma ◽  
Severe Asthma Exacerbation
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