Hussein A, von der Hardt H, Müller W, Schell S M
Monatsschr Kinderheilkd. 1986 Apr;134(4):192-6.
20 children (age range 0.8-14.7 years) with acute severe asthma were alternately randomized to receive one of two different treatment regimes. 10 children (control-group) received Salbutamol inhalation (75 micrograms/kg in 2 ml Saline every two hours). 10 children (reproterol-group) received reproterol infusion (0.2-2.0 micrograms/kg/min in Saline) and inhaled Saline only. Other therapy regimen were identical in both groups: Theophylline infusion, i.v. Prednisolone, adequate fluids intake and oxygen insufflation. Age, severity and maintenance therapy of asthma, and severity of the acute episode, were not significantly different in both groups. Treatment efficacy, assessed with a simple clinical score, the heart and respiratory rates, the peak expiratory flow (PEF) and the blood gases, was comparable in both groups. Side effects, i.e. tachycardia, blood pressure changes and tremor, were also similar and clinically not relevant in both groups. In two children, who previously needed repeated mechanical ventilation, severe respiratory failure could be successfully controlled only when the reproterol dose was raised 10 folds (2.0 micrograms/kg/min). Reproterol infusion can be recommended in children with acute severe asthma, who do not respond satisfactorily to current therapy regimen, particularly in children who previously experienced numerous intubations.
20名急性重症哮喘患儿（年龄范围0.8 - 14.7岁）被交替随机分组，接受两种不同治疗方案中的一种。10名患儿（对照组）接受沙丁胺醇吸入治疗（每两小时吸入2毫升生理盐水中含75微克/千克的沙丁胺醇）。10名患儿（瑞普特罗组）接受瑞普特罗静脉输注（0.2 - 2.0微克/千克/分钟溶于生理盐水中）且仅吸入生理盐水。两组的其他治疗方案相同：静脉输注茶碱、静脉注射泼尼松龙、充足的液体摄入和吸氧。两组在哮喘的年龄、严重程度及维持治疗情况，以及急性发作的严重程度方面均无显著差异。通过简单临床评分、心率和呼吸频率、呼气峰值流速（PEF）及血气分析评估的治疗效果在两组中相当。副作用，即心动过速、血压变化和震颤，在两组中也相似且在临床上无相关性。在两名之前需要反复机械通气的患儿中，仅当瑞普特罗剂量提高10倍（2.0微克/千克/分钟）时，严重呼吸衰竭才能得到成功控制。对于当前治疗方案反应不佳的急性重症哮喘患儿，尤其是之前经历过多次插管的患儿，可推荐使用瑞普特罗静脉输注治疗。
