title: Beneficial effects of warmed humidified oxygen combined with nebulized albuterol and ipratropium in pediatric patients with acute exacerbation of asthma in winter months.
abstract: BACKGROUND
  The objective of this study was to determine whether a combination of nebulized albuterol and ipratropium with warmed humidified oxygen would be more beneficial when compared to the same combination with humidified oxygen at room temperature. Albuterol alone was tested in the same settings.
  
  
  METHODS
  All patients between 6 and 17 years of age who presented to a pediatric emergency department in the winter months with acute exacerbation of bronchial asthma were given a combination of nebulized albuterol and ipratropium with warmed or room temperature humidified oxygen. Peak flow was measured before and after the treatment.
  
  
  RESULTS
  Sixty patients were enrolled in the study, with 15 subjects in each group. The mean increase in peak flow in the albuterol-ipratropium with warm humidified oxygen group was 52.6, and in the albuterol-ipratropium with humidified oxygen at room temperature group, it was 26.2. The results of the albuterol with warmed humidified oxygen and with humidified oxygen at room temperature groups were 20.6 and 34.3, respectively. The differences between the groups were statistically significant.
  
  
  CONCLUSIONS
  Our study shows that warmed humidified oxygen given along with the combination of nebulized albuterol and ipratropium is more beneficial for pediatric patients having an acute exacerbation of bronchial asthma in the winter months when compared to nebulized albuterol alone with warmed humidified oxygen, nebulized albuterol alone with room temperature humidified oxygen, or a combination of nebulized albuterol and ipratropium with room temperature humidified oxygen.
authors.affiliation: Department of Emergency Medicine, Metropolitan Hospital Center, 1901 First Avenue, New York, NY 10029, USA.
authors.forename: Kumara
authors.initials: K
authors.lastname: Nibhanipudi
authors.forename: Getaw Worku
authors.initials: GW
authors.lastname: Hassen
authors.forename: Arthur
authors.initials: A
authors.lastname: Smith
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006813:Humidity; D009241:Ipratropium / Q000008:administration & dosage*; D008297:Male; D009330:Nebulizers and Vaporizers; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010366:Peak Expiratory Flow Rate; D012621:Seasons
chemical_list: D001993:Bronchodilator Agents; D009241:Ipratropium; D000420:Albuterol