Eficacia de la administración precoz de bromuro de ipratropio nebulizado en niños con crisis asmática
Efficacy of early administration of nebulized ipratropium bromide in children with acute asthma attack
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"apellidos" => "Benito Fernández" "email" => array:1 [ 0 => "jbenito@hcru.osakidetza.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Mintegui Raso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Sánchez Echaniz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Vázquez Ronco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "J.I." "apellidos" => "Pijoan Zubizarreta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Urgencias de Pediatría. Departamento de Pediatría" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Epidemiología Clínica.Hospital de Cruces. Barakaldo. Vizcaya" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Urgencias de Pediatría. Departamento de Pediatría. Hospital de Cruces. Pl. de Cruces, s/n. 48903 Barakaldo. Vizcaya" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Efficacy of early administration of nebulized ipratropium bromide in children with acute asthma attack" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-02-29" "fechaAceptado" => "2000-05-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186445" "palabras" => array:3 [ 0 => "Bromuro de ipratropio" 1 => "Crisis asmática" 2 => "Niños" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186444" "palabras" => array:4 [ 0 => "Ipratropium bromide" 1 => "Hospital admission rates" 2 => "Asthma attack" 3 => "Children" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la eficacia de la administración conjunta de bromuro de ipratropio y salbutamol nebulizado en el tratamiento de las crisis asmáticas moderadas-severas de los niños.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 102 pacientes con edades comprendidas entre 5 meses y 16 años, asignándoles, de forma aleatoria y doble ciego, a 2 grupos. Todos los pacientes recibieron tratamiento con salbutamol nebulizado, 0,2 mg/kg y corticoïdes por vía oral, 1 mg/kg. El grupo A recibió 2 dosis de bromuro de ipratropio nebulizado (250 mg/dosis) y el grupo B placebo. Antes de iniciar el tratamiento y a los 120 minutos, se valoró por escala clínica (frecuencia cardíaca, frecuencia respiratoria, disnea, retracciones y sibilancias) puntuándola de 0 a 5 y la saturación de oxígeno.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Basalmente, no se observaron diferencias en la puntuación de la escala clínica (grupo A: 4,45; grupo B: 4,43) ni en la saturación de oxígeno (grupo A: 93,05%, grupo B: 92,78%). A los 120 minutos de iniciado el estudio, tampoco se observaron diferencias significativas entre ambos grupos de estudio: escala clínica (grupo A: 2,45; grupo B: 2,74) y saturación de oxígeno (grupo A: 94,33%; grupo B: 94,03%). El porcentaje de ingresos fue inferior en el grupo A (35%) que en el grupo B (53%) (p = 0,07). En los pacientes con crisis más graves (escala inicial = 5), tanto la puntuación de la escala clínica tras el tratamiento (grupo A: 2,69; grupo B: 3,32), como el porcentaje de ingresos (grupo A: 39%; grupo B: 73%) resultaron significativamente inferiores en el grupo A (p < 0,05).</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La administración de bromuro de ipratropio combinado a dosis repetidas de salbutamol nebulizado tiene un efecto clínico beneficioso muy discreto en relación con los niños que reciben únicamente salbutamol. Este efecto beneficioso se traduce en una reducción en las tasas de ingreso, sobre todo en los pacientes más graves.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine the efficacy of adding ipratropium bromide to nebulized salbutamol in the treatment of children with moderate-to-severe acute asthma attacks.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A total of 102 patients aged between 5 months and 16 years were included in a double-blind randomized trial. All patients were given nebulized salbutamol (0.2 mg/kg) and oral steroids (1 mg/kg). Patients in group A received two doses of nebulized ipratropium bromide (250 mg per dose) and patients in group B were given placebo. Oxygen saturation (SaO2) and a clinical score (heart rate, respiratory rate, dyspnea, retraction of the intercostal spaces, and wheezing) rated from 0 to 5 were measured before treatment and at 120 min.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Patients in both groups showed similar SaO2 values and clinical scores at baseline (group A, 93.05% and 4.45; group B, 92.78% and 4.43) and at 120 min (group A, 94.33% and 2.45; group B, 94.03% and 2.74), but the percentage of patients admitted to the hospital was higher in group B than in group A (53% vs 35%, p = 0.07). In the subset of patients with the most severe attacks (baseline score 5), the clinical score after treatment and the percentage of admissions were significantly higher in group B (n = 22) than in group A (n = 23) (3.32 vs 2.69 and 73% vs 39%, p < 0.05).</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Coadministration of ipratropium bromide and repeat doses of nebulized salbutamol produced a small beneficial clinical effect compared with administration of nebulized salbutamol alone. This beneficial effect was related to a decrease in the hospitalization rate, particularly in patients with severe asthma attacks.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 31 | 19 | 50 |
| 2024 Octubre | 271 | 114 | 385 |
| 2024 Septiembre | 210 | 88 | 298 |
| 2024 Agosto | 207 | 146 | 353 |
| 2024 Julio | 203 | 102 | 305 |
| 2024 Junio | 216 | 119 | 335 |
| 2024 Mayo | 191 | 162 | 353 |
| 2024 Abril | 220 | 179 | 399 |
| 2024 Marzo | 212 | 150 | 362 |
| 2024 Febrero | 199 | 124 | 323 |
| 2024 Enero | 199 | 107 | 306 |
| 2023 Diciembre | 242 | 81 | 323 |
| 2023 Noviembre | 239 | 128 | 367 |
| 2023 Octubre | 177 | 162 | 339 |
| 2023 Septiembre | 162 | 106 | 268 |
| 2023 Agosto | 120 | 81 | 201 |
| 2023 Julio | 124 | 103 | 227 |
| 2023 Junio | 168 | 132 | 300 |
| 2023 Mayo | 227 | 114 | 341 |
| 2023 Abril | 177 | 52 | 229 |
| 2023 Marzo | 161 | 74 | 235 |
| 2023 Febrero | 119 | 62 | 181 |
| 2023 Enero | 114 | 68 | 182 |
| 2022 Diciembre | 94 | 57 | 151 |
| 2022 Noviembre | 156 | 87 | 243 |
| 2022 Octubre | 236 | 113 | 349 |
| 2022 Septiembre | 145 | 56 | 201 |
| 2022 Agosto | 99 | 67 | 166 |
| 2022 Julio | 78 | 63 | 141 |
| 2022 Junio | 80 | 56 | 136 |
| 2022 Mayo | 71 | 65 | 136 |
| 2022 Abril | 70 | 77 | 147 |
| 2022 Marzo | 88 | 70 | 158 |
| 2022 Febrero | 70 | 45 | 115 |
| 2022 Enero | 95 | 60 | 155 |
| 2021 Diciembre | 78 | 69 | 147 |
| 2021 Noviembre | 79 | 88 | 167 |
| 2021 Octubre | 87 | 76 | 163 |
| 2021 Septiembre | 69 | 76 | 145 |
| 2021 Agosto | 107 | 46 | 153 |
| 2021 Julio | 101 | 44 | 145 |
| 2021 Junio | 90 | 72 | 162 |
| 2021 Mayo | 113 | 69 | 182 |
| 2021 Abril | 253 | 99 | 352 |
| 2021 Marzo | 168 | 46 | 214 |
| 2021 Febrero | 94 | 36 | 130 |
| 2021 Enero | 92 | 38 | 130 |
| 2020 Diciembre | 92 | 26 | 118 |
| 2020 Noviembre | 70 | 27 | 97 |
| 2020 Octubre | 69 | 19 | 88 |
| 2020 Septiembre | 46 | 7 | 53 |
| 2020 Agosto | 81 | 13 | 94 |
| 2020 Julio | 84 | 24 | 108 |
| 2020 Junio | 79 | 15 | 94 |
| 2020 Mayo | 94 | 32 | 126 |
| 2020 Abril | 112 | 65 | 177 |
| 2020 Marzo | 117 | 35 | 152 |
| 2020 Febrero | 98 | 39 | 137 |
| 2020 Enero | 211 | 24 | 235 |
| 2019 Diciembre | 221 | 30 | 251 |
| 2019 Noviembre | 222 | 21 | 243 |
| 2019 Octubre | 103 | 20 | 123 |
| 2019 Septiembre | 109 | 21 | 130 |
| 2019 Agosto | 170 | 29 | 199 |
| 2019 Julio | 201 | 70 | 271 |
| 2019 Junio | 215 | 26 | 241 |
| 2019 Mayo | 285 | 44 | 329 |
| 2019 Abril | 212 | 26 | 238 |
| 2019 Marzo | 142 | 16 | 158 |
| 2019 Febrero | 55 | 18 | 73 |
| 2019 Enero | 57 | 15 | 72 |
| 2018 Diciembre | 77 | 20 | 97 |
| 2018 Noviembre | 100 | 31 | 131 |
| 2018 Octubre | 82 | 13 | 95 |
| 2018 Septiembre | 54 | 7 | 61 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 8 | 0 | 8 |
| 2018 Abril | 35 | 0 | 35 |
| 2018 Marzo | 29 | 0 | 29 |
| 2018 Febrero | 20 | 0 | 20 |
| 2018 Enero | 45 | 0 | 45 |
| 2017 Diciembre | 28 | 0 | 28 |
| 2017 Noviembre | 69 | 0 | 69 |
| 2017 Octubre | 41 | 0 | 41 |
| 2017 Septiembre | 44 | 0 | 44 |
| 2017 Agosto | 37 | 0 | 37 |
| 2017 Julio | 26 | 0 | 26 |
| 2017 Junio | 38 | 10 | 48 |
| 2017 Mayo | 48 | 7 | 55 |
| 2017 Abril | 28 | 3 | 31 |
| 2017 Marzo | 32 | 4 | 36 |
| 2017 Febrero | 56 | 2 | 58 |
| 2017 Enero | 30 | 3 | 33 |
| 2016 Diciembre | 60 | 10 | 70 |
| 2016 Noviembre | 103 | 6 | 109 |
| 2016 Octubre | 120 | 7 | 127 |
| 2016 Septiembre | 91 | 7 | 98 |
| 2016 Agosto | 67 | 5 | 72 |
| 2016 Julio | 38 | 6 | 44 |
| 2016 Junio | 2 | 0 | 2 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 2 | 0 | 2 |
| 2016 Febrero | 2 | 0 | 2 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 14 | 11 | 25 |
| 2015 Junio | 16 | 0 | 16 |
| 2015 Mayo | 15 | 0 | 15 |
| 2015 Abril | 21 | 5 | 26 |
| 2015 Marzo | 10 | 0 | 10 |
| 2015 Febrero | 19 | 0 | 19 |
| 2015 Enero | 20 | 0 | 20 |
| 2014 Diciembre | 33 | 2 | 35 |
| 2014 Noviembre | 19 | 1 | 20 |
| 2014 Octubre | 12 | 0 | 12 |
| 2014 Septiembre | 14 | 4 | 18 |
| 2014 Agosto | 22 | 1 | 23 |
| 2014 Julio | 17 | 2 | 19 |
| 2014 Junio | 28 | 2 | 30 |
| 2014 Mayo | 42 | 1 | 43 |
| 2014 Abril | 26 | 4 | 30 |
| 2014 Marzo | 26 | 7 | 33 |
| 2014 Febrero | 20 | 8 | 28 |
| 2014 Enero | 22 | 6 | 28 |
| 2013 Diciembre | 28 | 11 | 39 |
| 2013 Noviembre | 21 | 14 | 35 |
| 2013 Octubre | 31 | 18 | 49 |
| 2013 Septiembre | 34 | 18 | 52 |
| 2013 Agosto | 16 | 22 | 38 |
| 2013 Julio | 8 | 3 | 11 |
| 2013 Junio | 4 | 3 | 7 |
| 2013 Mayo | 7 | 4 | 11 |
| 2013 Abril | 2 | 4 | 6 |
| 2013 Marzo | 12 | 2 | 14 |
| 2013 Febrero | 28 | 1 | 29 |
| 2013 Enero | 22 | 2 | 24 |
| 2012 Diciembre | 14 | 0 | 14 |
| 2012 Noviembre | 13 | 2 | 15 |
| 2012 Octubre | 11 | 1 | 12 |
| 2012 Septiembre | 2 | 1 | 3 |
| 2000 Agosto | 2692 | 0 | 2692 |
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