論文

査読有り 本文へのリンクあり
2019年7月

Low-dose l-isoproterenol versus salbutamol in hospitalized pediatric patients with severe acute exacerbation of asthma: A double-blind, randomized controlled trial

Allergology International
  • Toshio Katsunuma
  • ,
  • Takao Fujisawa
  • ,
  • Takanobu Maekawa
  • ,
  • Kenichi Akashi
  • ,
  • Yukihiro Ohya
  • ,
  • Yuichi Adachi
  • ,
  • Koji Hashimoto
  • ,
  • Mihoko Mizuno
  • ,
  • Takanori Imai
  • ,
  • Mari S. Oba
  • ,
  • Mayumi Sako
  • ,
  • Yasuo Ohashi
  • ,
  • Hidefumi Nakamura

68
3
開始ページ
335
終了ページ
341
記述言語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.alit.2019.02.001

© 2019 Japanese Society of Allergology Background: Although the guidelines in most countries do not recommend continuous inhalation of l-isoproterenol to treat pediatric patients with acute severe exacerbation of asthma, lower dose of l-isoproterenol has been widely used in Japan. To determine whether the efficacy of low-dose l-isoproterenol was superior to that of salbutamol, we conducted a double-blind, randomized controlled trial. Methods: Hospitalized patients aged 1–17 years were eligible if they had severe asthma exacerbation defined by the modified pulmonary index score (MPIS). Patients were randomly assigned (1:1) to receive inhalation of l-isoproterenol (10 μg/kg/h) or salbutamol (500 μg/kg/h) for 12 hours via a large-volume nebulizer with oxygen. The primary outcome was the change in MPIS from baseline to 3 hours after starting inhalation. Trial registration number UMIN000001991. Results: From December 2009 to October 2013, 83 patients (42 in the l-isoproterenol group and 41 in the salbutamol group) were enrolled into the study. Of these, one patient in the l-isoproterenol group did not receive the study drug and was excluded from the analysis. Compared with salbutamol, l-isoproterenol reduced MPIS more rapidly. Mean (SD) changes in MPIS at 3 hours were −2.9 (2.5) in the l-isoproterenol group and −0.9 (2.3) in the salbutamol group (difference −2.0, 95% confidence interval −3.1 to −0.9; P < 0.001). Adverse events occurred in 1 (2%) and 11 (27%) patients in the l-isoproterenol and salbutamol groups, respectively (P = 0.003). Hypokalemia and tachycardia occurred only in the salbutamol group. Conclusions: Low-dose l-isoproterenol has a more rapid effect with fewer adverse events than salbutamol.

リンク情報
DOI
https://doi.org/10.1016/j.alit.2019.02.001
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30846304
Scopus
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062265808&origin=inward 本文へのリンクあり
Scopus Citedby
https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85062265808&origin=inward

エクスポート
BibTeX RIS