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Review: ipratropium bromide with β-agonists improves pulmonary function and reduces admissions to hospital in acute asthma

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 QUESTION: In adults with acute asthma treated with β-agonists, does the addition of ipratropium bromide improve pulmonary function during the first 90 minutes of treatment and reduce the rate of admissions to hospital?

Data sources

Studies were identified by searching Medline (1978 to April 1999), Current Contents, Science Citation Index, review articles, bibliographies of relevant articles, and the register of the Medical Editors' Trial Amnesty and by contacting experts and the manufacturer of ipratropium.

Study selection

English language studies were selected if they were randomised, doubled blind, controlled trials (RCTs); patients (>16 y of age) had acute asthma and were treated in an emergency department with β-agonists; pulmonary function was measured as a continuous variable; and sufficient data were available to calculate effect sizes.

Data extraction

Data were extracted on year and source of publication, country, number of patients, patient characteristics, dose and route of all medications, spirometric measures used, mean …

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