PEAK EXPIRATORY FLOW RATE WITH SALBUTAMOL PLUS IPRATROPIUM BROMIDE VERSUS SALBUTAMOL ALONE IN ACUTE ASTHMA IN CHILDREN IN LAHORE, PAKISTAN: A RANDOMIZED CONTROLLED TRIAL

Background: Paediatric asthma usually presents with acute exacerbation and requires hospital admission and emergency management. The objective of this study was to compare the peak expiratory flow rate (PEFR) with salbutamol plus ipratropium bromide versus salbutamol alone in acute asthma in children in Lahore, Pakistan. Material & Methods: This randomized controlled trial was undertaken at The Children's Hospital and The Institute of Child Health, Lahore, Pakistan from 14-04-2017 to 17-10-2017. One hundred children with acute asthma with age 2-12 years were enrolled. Fifty patients each were randomly assigned to experimental and control groups by lottery method. At presentation, PEFR was measured by using a peak flow meter. Experimental group received three doses of 2.5 mg salbutamol and 500 mcg of ipratropium at 20 minutes intervals. Control group received three doses of 2.5 mg salbutamol alone. PEFR was again measured after 60 minutes. Results: Mean age in experimental group was 9.60 +/- 2.86 years, whereas it was 8.68 +/- 3.28 years in control group, almost similar. Mean weight in experimental group was 29.50 +/- 8.26 kg, whereas it was 28.24 +/- 10.07 kg in control group, almost similar. Baseline mean PEFR% was 43.18 +/- 4.25 in experimental, while it was 42.48 +/- 4.82 in control group. Mean PEFR% at 60 minutes after intervention was 82.88 +/- 7.54 in experimental, while it was 60.04 +/- 6.05 in control group. PEFR% was higher in experimental group showing its better effect than the control group (p<.00001). Conclusion: The peak expiratory flow rate was higher with salbutamol plus ipratropium bromide versus salbutamol alone in acute asthma in children in Lahore, Pakistan.