Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
---|---|---|---|---|---|
Schuh S. et al 1990 Canada | 40 infants (6 weeks - 2 years) Nebulised salbutamol vs placebo | Randomised double blind placebo controlled trial | Respiratory rate | Significantly greater improvement with salbutamol | No microbiological confirmation of diagnosis in 16/40 (40%) patients. Clinical score inadequate to reflect the respiratory distress of the child. No information on statistical analysis of base line characterstics. |
Heart rate | Significantly improved after second dose of salbutamol | ||||
Accessory muscle score | Significantly greater improvement with salbutamol | ||||
Wheezing score | No significant difference | ||||
Oxygen saturation | Significantly greater improvement with salbutamol | ||||
KlassenTP. et al 1991 Canada | 83 children (1-21 months) Nebulised salbutamol vs placebo | Randomised double blind placebo controlled trial | Clinical score | No significant difference after 1 hour | Exclusion of patients with severe disease. No microbiological confirmation of diagnosis in 42 % of patients. |
Respiratory rate | No significant difference | ||||
Oxygen saturation | No significant difference | ||||
Gadomski AM .et al 1994 Egypt | 128 infants (less than 18 months). Nebulised salbutamol vs nebulised saline vs oral salbutamol vs oral placebo. | Double blind placebo controlled trial | Respiratory rate | No significant difference | Microbiological confirmation of diagnosis in only 42% of patients. No data regarding individual or family history of atopy. |
Clinical score | No significant difference | ||||
Oxygen saturation | No significant difference | ||||
Heart rate | Significant increase in nebulised salbutamol group compared to placebo | ||||
Gadomski AM. et al 1994 USA | 88 infants (median age - 5.5 months) Nebulised salbutamol vs nebulised saline vs oral salbutamol vs oral placebo. | Randomised double blind placebo controlled trial | Respiratory rate | No significant difference | No statistical information about comparison of base line characterstics. State (falling asleep, waking up) of infant not controlled. |
Heart rate | No significant difference | ||||
Clinical score | No significant difference | ||||
Oxygen saturation | No significant difference | ||||
Chowdhury D. et al 1995 Saudi Arabia | 89 children (23 days-11 months). Nebulised salbutamol vs nebulised ipratropium bromide vs nebulised saline & ipratropium bromide vs saline. | Randomised placebo controlled clinical trial | Clinical score | No significant difference | No blinding. Not all patients included. |
Length of hospital stay | No significant difference | ||||
Goh A. et al 1997 Singapore | 120 children (age less than 2 years). Nebulised salbutamol vs nebulised ipratropium bromide vs nebulised saline vs humidified oxygen. | Randomised double blind placebo controlled trial | Length of hospital stay | No significant difference | Second control group added later. |
Clinical severity score | No significant difference | ||||
Dobson JV. et al 1998 USA | 52 patients (age less than 2 years). Nebulised salbutamol vs saline. | Randomised double blind placebo controlled trial | Clinical severity score | No significant difference | Study too small for adequately powered survival analysis. |
Length of hospital stay | No significant difference | ||||
Frequency of adverse events | No significant difference | ||||
Improvement in oxygen saturation | No significant difference | ||||
Ho L. et al 1991 Australia | 21 infants (3 weeks-6 months). Nebulised salbutamol vs placebo. | Randomised double blind placebo controlled trial | Oxygen saturation profile | Significant desaturation after salbutamol | Arbitary choice of 4% drop in saturation as a tool for statistical analysis. Definition of excluded severely ill children not mentioned. |
Time for saturation to normailse | Significantly longer time after salbutamol | ||||
Time to reach minimum saturationn | No significant difference | ||||
Wang EE.et al 1992 Canada | 62 children (2 months- 2 years). Nebulised salbutamol or placebo vs ipratropium or placebo. | Randomised double blind placebo controlled trial | Oxygen saturation | No significant difference | Selection bias. Use of variety of different significance levels. No microbiological confirmation of diagnosis in 73% of patients. |
Clinical severity score | No significant difference | ||||
Length of hospital stay | No significant difference |