Evidence Based Medicine

Nama NPM Kelompok

: Raihan Alhazmi : 1102013242 : B11

Fakultas Kedokteran ni!ersitas "arsi 2013#2014

Nama : Raihan Alhazmi NPM : 1102013242 Kelompok : B11 SKENAR !: $ntan% 14 tahun men&alami sesak na'as (ukup parah setelah men)apu halaman rumah* +esak na'as disertai den&an ,atuk ,erdahak% dan ,ersin-,ersin% serta $ntan han)a ,isa ,er,i(ara terputus-putus* +e,elum men)apu halaman dia merasa ,aik-,aik sa.a* $ntan ,isa melakukan akti!itas apapun asalkan tidak terkena de,u* /idalam keluar&a $ntan terdapat an&&ota keluar&a )an& memiliki ri0a)at seperti $ntan .ika terkena de,u* 1ika seran&an sesak na'as $ntan kam,uh% $ntan selalu meminum o,at dari dokter )an& men&andun& sal,utamol den&an ipratropium ,romide% tetapi $ntan .u&a di,eri o,at oleh dokter lain )an& han)a men&andun& sal,utamol sa.a* PER"AN#AAN K$ N S: Pada pasien )an& men&alami seran&an asma ,erat% apakah pem,erian sal,utamol den&an ipratropium ,romide ,ila di,andin&kan den&an sal,utamol sa.a% akan memper(epat proses pen)em,uhan2 K!MP!NEN P %!: Patient : Pasien )an& men&alami seran&an asma ,erat $nter!ention : +al,utamol den&an ipratropium ,romide 3ontrol : +al,utamol sa.a 4ut(ome : Proses pen)em,uhan sesak le,ih (epat 5)pe o' 6uestion: 5herap) 5)pe o' +tud): Randomized 3ontrol 5rial KA"A K&N% : asthma AN/ (hild7 AN/ ipratropium ,romide AN/ sal,utamol PEM $ 'AN S "&S: 000*e,s(ohost*(om $ M "AS : 8ast 9 )ears: Full 5e;t: A,stra(t A!aila,le: <n&ish 8an&ua&e* 'AS $ PEN%AR AN:
1

R$3AR/4 $RAMA$N% et al. $nhaled Al,utamol Plus $pratropium in Moderate and +e!ere Asthma 3rises in 3hildren* Emergency Unit, Emergency Department, Maternity-Childrens Hospital, Asuncin National Uni ersity Asuncin, !araguay. 2011: 4=: 2>= ? 303*

AR" KE$ #AN( ) P $ ': @1A $AMP RAN AR" KE$ #AN( ) P $ ': Ba(k&round: 5he (om,ination o' inhaled B@2A a&onists and anti(holiner&i(s is re(ommended 'or (hildren 0ith a(ute asthma% althou&h there are 'e0 randomized (ontrolled trials* 5he aim o' the stud) 0as to determine 0hether sal,utamol plus ipratropium ,romide impro!es o;)&enation and lun& 'un(tion and redu(es the 'reCuen() o' hospitalization in (hildren 0ith asthma (rises* Methods: A prospe(ti!e% randomized% dou,le-,lind stud) o' (hildren a&ed 2-1= )ears 0ith moderate to se!ere asthma (rises* Patients 0ere e!aluated usin& the asthma s(ore and spirometr)* 5he) re(ei!ed si; ne,ulizations o' sal,utamol plus pla(e,o or sal,utamol plus ipratropium and 0ere ree!aluated at 30% D0% >0% 120% and 240 minutes% at 0hi(h time it 0as de(ided 0hether the) 0ere to ,e admitted* Results: A total o' >E patients (ompleted the stud)% 4> in the sal,utamol plus ipratropium &roup and 4= in the sal,utamol-onl) &roup* 5here 0ere no di''eren(es in the status at ,aseline ,et0een the t0o &roups* 3hildren treated 0ith sal,utamol plus ipratropium presented a &reater impro!ement in (lini(al state and lun& 'un(tion and reCuired hospitalization less 'reCuentl) @1=*4FA than (hildren in the sal,utamol &roup @43*=FA @p G *00EA* $mpro!ement 0as more marked in (hildren 0ith se!ere asthma (rises than in those 0ith moderate (rises* 5he e''e(t o' sal,utamol plus ipratropium 0as similar in (hildren o!er = )ears o' a&e and in )oun&er (hildren* 3on(lusions: +al,utamol plus ipratropium ,romide impro!es lun& 'un(tion in asthmati( (hildren 0ith moderate to se!ere asthma (rises% independentl) o' a&e* 5he e''e(t is &reater in (hildren 0ith se!ere (rises% 0ith a su,stantial redu(tion in the need 'or hospitalization*