Table 2-2
Citation Study group Study type (level of evidence) Outcome Key results Comments
Plotnick and Ducharme (2000) Systematic review of 13 randomised controlled trials of ipratropium added to β2 agonists in acute childhood asthmaSystematic review (level 1a)Hospital admission Need for additional bronchodilators, lung function (% change in FEV1 from predicted or baseline)All severities of asthma: 25% reduction, odds ratio 0.75 (95% CI: 0.62 to 0.89) NNT = 12 Severe asthma only: OR 0.71 (95% CI 0.58 to 0.89) NNT = 7 OR = 0.81 (95% CI: 0.66 to 0.99) 9.68% (95% CI: 5.70 to 13.68)Reduction in hospital admission rate for children receiving multiple doses in fixed protocol. Significant reduction only seen for subgroup with “severe” asthma at presentation. Reduced need for additional brochodilators significant only for children receiving ipratropium and β2 agonist in multiple dose protocols
Cravenet al (2001)210 childen aged 1–18 years, with acute exacerbations of asthma (104 received ipratropium, 106 in control group)Randomised controlled trial (level 1b)Length of hospital stay (hours)No significant difference between treatment and control groups (p = 0.46)In subgroup of 35 children over 6 years old there was a trend towards shorter hospital stay, but this was not significant
Time taken to proceed through four stages of an asthma care plan No significant difference between treatment and control groups (p = 0.37)