Abstract

Objectives: The objective of the study was to determine the accuracy of pulmonary asthma score in predicting severity of asthma exacerbation and comparison of efficacy between levosalbutamol and ipratropium combination over levosalbutamol nebulization  in reversing airflow obstruction and improving oxygenation, evaluated using the pulmonary asthma score, SaO₂, and PEFR in mild and moderate asthma.

Methods: A prospective, randomized, study was performed in RMMCH pediatric emergency department. Children between 6 and 12 years of age who presented with mild to moderate asthma exacerberations were included in the study. They were randomly allocated into two different groups: one nebulized with levosalbutamol alone and another with addition of ipratropium bromide to levosalbutamol. Baseline Peak expiratory flow rate and  final absolute values or change from baseline 60–120 minutes after the inhalation are measured. Patients were evaluated using the pulmonary asthma score⁴.

Results: After treatment there is improvement  in the mean pulmonary asthma scores  and PEFR percentage in  A+B group than A group, but it is not statistically significant (p value >0.05). There is statistically significant improvement in pulmonary asthma score and PEFR in each of the groups before and after nebulization  and pulmonary asthma score has a sensitivity of 66.7% and 65.6% in diagnosing  severity of asthma  in relation to PEFR.

Keywords: Levosalbutamol, Ipratropium bromide, peak expiratory flow rate, pulmonary asthma score (PAS).