Indian journal of pediatrics
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Randomized Controlled Trial Clinical Trial
Lower arrythmogenic risk of low dose albuterol plus ipratropium.
Wheezy infants are in need of urgent bronchodilatation owing to their intermittent bronchoconstriction. beta 2 agonists are frequently used in emergencies and have previously shown to increase the QT dispersion (QTd), which may be associate with high risk of cardiac arrhythmia, in asthmatics. However, effect of low dose beta 2 agonist therapy in combination with the anticholinergic agents on QTd in wheezy infants is not known. This study aimed to assess the effect of standard dose of nebulized albuterol (NAB) and low doses of NAB combined with ipratropium-bromide (NIB) on QTd in wheezy infants. ⋯ Our results suggest that, while clinical improvement is same, the increase of the QT dispersion is more prominent with the use of standard dose of NAB compared to low dose NAB plus NIB therapy. So, low dose of beta 2 agonist in combination with anticholinergic agents may much safer than the use of standard dose of beta 2 agonists alone in regard to preventing the possibility of arrythmogenic effects in wheezy infants with acute exacerbation.