ReviewA meta-analysis of the effects of ipratropium bromide in adults with acute asthma
Section snippets
Literature search and selection of studies
A computerized search was conducted to identify literature on the topic of ipratropium bromide use in patients with acute adult asthma. We searched for studies using MEDLINE for the years 1978 to 1999 (April). The following MeSH terms were used in the search: N-isopropylatropine or ipratropium bromide and adult, acute asthma or status asthmaticus. The limits were English language, adults >16 years old, and clinical trials. Other sources of relevant articles were Current Contents, Science
Results
Sixty-five articles were identified in the initial Medline search (1978 to 1999); Science Citation and Current Contents identified 43 citations, with substantial overlap. Of these, reviewers thought that 23 papers were potentially eligible; most of the others were excluded because they were not clinical trials of patients with acute asthma. Reasons for subsequent exclusion were nonrandomized trial (n = 1) (17), pooled analysis of three previous trials (n = 1) (44), study conducted in
Discussion
The purpose of this meta-analysis was to determine whether inhaled ipratropium bromide provides an additive benefit to adults with acute asthma who are treated with beta-agonists. A secondary goal was to determine whether the admission rate is influenced by the combined treatment. Our analysis showed that ipratropium therapy resulted in a significant 10% improvement in FEV1 or peak flow. This result is similar to that seen in two meta-analyses of the treatment of children with acute asthma 53,
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