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SUMMARY
OF
RESULTS

STUDY TYPE DEFINED
OUTCOME KEY
RESULT COMMENTS

Intravenous
ß2‐agonists
for
 Meta‐analysis Pulmonary
function,
vital
 No
evidence
to
support
the
use
of
 Only
15
trials
met
the
inclusion
criteria.


acute
asthma
in
the
 (Cochrane
Review) signs,
arterial
gases,
 IV
ß2‐agonists
in
acute
asthma. Only
one
trial
examined
the
paediatric

emergency
department adverse
effects,
clinical
 
 age
range.
All
bar
one
study
had

(Travers
et
al.
2001) success. suboptimal
nebulised
therapy.

Randomised
trial
of
 RCT Recovery
time Intravenous
group
had
a
 Adequately
sized
trial
(n=29).


intravenous
salbutamol
in
 (no
longer
requiring
 signiQicantly
shorter
mean
 Demonstrates
that
an
early
IV
bolus
of

early
management
of
acute
 nebulised
therapy
every
 recovery
time
than
controls
(4.0
 15µg/kg
salbutamol
over
10mins
is
a
safe

severe
asthma
in
children 30mins). vs.
11.5
hours). and
effective
means
of
achieving
a
rapid

(Browne
et
al.
1997) clinical
response
in
acute
severe
asthma.

Intravenous
salbutamol
 RCT 1)
Improvement
in
Asthma
 No
difference
in
effectiveness
 Large
trial
(n=44).

bolus
compared
with
an
 Severity
Score
(ASS)
at
2
 between
salbutamol
and
 Subjects
were
non‐responders,
with
poor

aminophylline
infusion
in
 hours. aminophylline
at
2
hours
in
 response
to
3
prior
salbutamol

children
with
severe
 2)
Duration
of
oxygen
 improving
ASS. nebulisers.
IV
therapy
was
administered

asthma:
a
randomised
 therapy. Aminophylline
signiQicantly
 with
concurrent
nebulised
therapy,

controlled
trial 3)
Duration
of
hospital
 reduced
length
of
stay
(0.67
times
 accurately
representing
real‐life
clinical

(Roberts
et
al.
2003) stay. that
of
salbutamol
group)
and
 practice.
duration
of
oxygen
therapy
(7.0
vs.
 Well‐designed
trial
with
strong
statistical

17.8
hours). conclusions.

Randomized,
double‐blind,
 RCT 1)
Recovery
time
(no
 Adding
an
IV
bolus
of
15µg/kg
 Large
trial
(n=55).

placebo‐controlled
trial
of
 longer
requiring
nebulised
 salbutamol
to
a
regime
of
frequent
 Study
omitted
a
control
group
(i.e.
a

intravenous
salbutamol
 therapy
every
20mins) nebulised
salbutamol
and
IV
 group
treated
with
just
systemic
steroids

and
nebulized
ipratropium
 2)
Discharge
time
from
 steroids
improves
mean
recovery
 and
frequent
nebulised
salbutamol).

bromide
in
early
 emergency
department
 time
by
1.2
hours
compared
to
 Therefore
impossible
to
comment
on
the

management
of
severe
 (only
requiring
hourly
 adding
frequent
ipratropium
 efQicacy
of
IV
salbutamol
bolus,
only
that

acute
asthma
in
children
 nebulised
therapy) nebulisers. it
improves
outcome
compared
to

presenting
to
an
 frequent
nebulised
ipratropium.
emergency
department
(Browne
et
al.
2002)
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