Evidence map›Paper›PMID 35922522›Full record

Trial reportEuropean journal of pediatrics2022

Efficacy of a loading dose of IV salbutamol in children with severe acute asthma admitted to a PICU: a randomized controlled trial.

Shelley A Boeschoten, Corinne M P Buysse, Brenda C M de Winter, Joost van Rosmalen, Johan C de Jongste, Rogier C de Jonge, Sabien G J Heisterkamp, Job B van Woensel, Martin C J Kneyber, Annelies van Zwol and 3 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in European journal of pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Salbutamol in the Management of Asthma: A Review.International journal of molecular sciences · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 1 country.

Shelley A BoeschotenDepartment of Pediatric Surgery & Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands. s.boeschoten@erasmusmc.nl.
Corinne M P BuysseDepartment of Pediatric Surgery & Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Brenda C M de WinterDepartment of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands.
Joost van RosmalenDepartment of Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands.
Johan C de JongsteDepartment of Pediatric Pulmonology and Allergology, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Rogier C de JongeDepartment of Pediatric Surgery & Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Sabien G J HeisterkampPediatric Intensive Care Unit, Emma's Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Job B van WoenselPediatric Intensive Care Unit, Emma's Children's Hospital, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Martin C J KneyberPediatric Intensive Care Unit, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, the Netherlands.
Annelies van ZwolPediatric Intensive Care Unit, Radboud University Medical Center NL, Nijmegen, the Netherlands.
Annemie L M BoehmerDepartment of Pediatrics, Maasstad Hospital, Rotterdam, the Netherlands.
Matthijs de HoogDepartment of Pediatric Surgery & Intensive Care, Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Dutch collaborative PICU research network (SKIC)
Erasmus MC - Sophia Children’s Hospital · NLAmsterdam University Medical Centers · NLErasmus MC · NLMaasstad Ziekenhuis · NLRadboud University Nijmegen · NLUniversity Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The optimal dose regimen for intravenous (IV) treatment in children with severe acute asthma (SAA) is still a matter of debate. We assessed the efficacy of adding a salbutamol loading dose to continuous infusion with salbutamol in children admitted to a pediatric intensive care unit (PICU) with SAA. This multicentre, placebo-controlled randomized trial in the PICUs of four tertiary care children's hospitals included children (2-18 years) with SAA admitted between 2017 and 2019. Children were randomized to receive either a loading dose IV salbutamol (15 mcg/kg, max. 750 mcg) or normal saline while on continuous salbutamol infusion. The primary outcome was the asthma score (Qureshi) 1 h after the intervention. Analysis of covariance models was used to evaluate sensitivity to change in asthma scores. Serum concentrations of salbutamol were obtained. Fifty-eight children were included (29 in the intervention group). Median baseline asthma score was 12 (IQR 10-13) in the intervention group and 11 (9-12) in the control group (p = 0.032). The asthma score 1 h after the intervention did not differ significantly between the groups (p = 0.508, β-coefficient = 0.283). The median increase in salbutamol plasma levels 10 min after the intervention was 13 μg/L (IQR 5-24) in the intervention group and 4 μg/L (IQR 0-7) in the control group (p = 0.001). Side effects were comparable between both groups.

conclusionWe found no clinical benefit of adding a loading dose IV salbutamol to continuous infusion of salbutamol, in children admitted to the PICU with SAA. Clinically significant side effects from the loading dose were not encountered. WHAT IS KNOWN: • Pediatric asthma guidelines struggle with an evidence-based approach for the treatment of SAA beyond the initial steps of oxygen suppletion, repetitive administration of inhaled β2-agonists, and systemic steroids. • During an SAA episode, effective delivery of inhaled drugs is unpredictable due to severe airway obstruction. WHAT IS NEW: • This study found no beneficial effect of an additional loading dose IV salbutamol in children admitted to the PICU. • This study found no clinically significant side effects from the loading dose.

Indexed as

AsthmaStatus AsthmaticusAdministration, InhalationAlbuterolBronchodilator AgentsChildHumansIntensive Care Units, PediatricOxygenSaline SolutionAlbuterolBronchodilator AgentsOxygenSaline SolutionChildrenIntensive careIV salbutamol bolusSevere acute asthma, TherapyStatus asthmaticus

Identifiers

PMID35922522
PMCPMC9508206
OpenAlexW4289637691

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.