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.