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Evidence summaries

Intravenous Beta-2-Agonists for Acute Asthma in the Emergency Department

Intravenous beta-2-agonists appear to produce no benefits as compared to treatment given by inhalation. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 15 studies with a total of 584 subjects. Selective intravenous beta-2-agonists conferred no advantage over the comparator regimes. It was associated with lower PEFR after 60 min as compared to inhaled beta-2-agonist, although the difference was not statistically significant. There were no sub-groups in which this agent was shown to be effective. The use of IV beta2-agonists was associated with an non-significant increase in risk of autonomic side effects (2-12 times), and higher heart rates (4-10 beats per minute).

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies). Efficacy in the pediatric population remains unclear since too few pediatric clinical trials were identified.

References

  • Travers A, Jones AP, Kelly K, Barker SJ, Camargo CA, Rowe BH. Intravenous beta2-agonists for acute asthma in the emergency department. Cochrane Database Syst Rev 2001;(2):CD002988. [PubMed]

Primary/Secondary Keywords