氯胺酮与氨茶碱治疗儿童急性哮喘的随机对照试验。
Ketamine versus aminophylline for acute asthma in children: A randomized, controlled trial.
作者信息
Tiwari Abhimanyu, Guglani Vishal, Jat Kana Ram
机构信息
Department of Pediatrics, Government Medical College Hospital, Chandigarh, India.
Department of Pediatrics, Government Medical College Hospital, Chandigarh, India; Department of Pediatrics, All Institute of Medical Sciences, New Delhi, India.
出版信息
Ann Thorac Med. 2016 Oct-Dec;11(4):283-288. doi: 10.4103/1817-1737.191874.
BACKGROUND
There is a lack of consensus regarding second-line therapy in children with acute asthma who fail to the standard therapy. Ketamine had bronchodilator property and may be useful in the treatment of acute asthma.
OBJECTIVE
The objective of this study was to evaluate the efficacy and safety of ketamine as compared to aminophylline in children with acute asthma who respond poorly to the standard therapy.
METHODS
This randomized controlled trial included patients with acute asthma having Pediatric Respiratory Assessment Measure (PRAM) score ≥5 at 2 h of standard therapy. The enrolled patients received either intravenous (IV) ketamine or IV aminophylline. Primary outcome measure was change in PRAM score at the end of intervention. Secondary outcome measures included adverse effects, change in POand PCO, need for mechanical ventilation, and duration of hospital stay.
RESULTS
The trial included 24 patients each in ketamine and aminophylline groups. The baseline parameters were similar between the groups. The primary outcome was similar in both the groups with a change in PRAM score of 4.00 ± 1.25 and 4.17 ± 1.68 ( = 0.699) in ketamine and aminophylline groups, respectively. The secondary outcomes were not different between the groups.
CONCLUSION
Ketamine and aminophylline were equally effective for children with acute asthma who responded poorly to the standard therapy.
背景
对于标准治疗无效的急性哮喘儿童，二线治疗方案尚无共识。氯胺酮具有支气管扩张特性，可能对急性哮喘治疗有效。
目的
本研究旨在评估氯胺酮与氨茶碱相比，对标准治疗反应不佳的急性哮喘儿童的疗效和安全性。
方法
这项随机对照试验纳入了在标准治疗2小时时小儿呼吸评估量表（PRAM）评分≥5的急性哮喘患者。入选患者接受静脉注射氯胺酮或静脉注射氨茶碱。主要结局指标是干预结束时PRAM评分的变化。次要结局指标包括不良反应、动脉血氧分压（PO）和二氧化碳分压（PCO）的变化、机械通气需求以及住院时间。
结果
氯胺酮组和氨茶碱组各纳入24例患者。两组的基线参数相似。两组的主要结局相似，氯胺酮组和氨茶碱组PRAM评分变化分别为4.00±1.25和4.17±1.68（P = 0.699）。两组的次要结局无差异。
结论
对于对标准治疗反应不佳的急性哮喘儿童，氯胺酮和氨茶碱疗效相当。
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