To determine whether addition of ipratropium bromide to salbutamol nebulisations produces significantly greater bronchodilation in young children presenting to an emergency department with an acute attack of asthma

Inclusion Criteria:

• Boys or girls between 3 and 6 years old
• Presenting to emergency departments with an acute asthmatic attack
• Requiring nebulised bronchodilator therapy
• Rint increased by 200 % compared to theoretical Rint
• Signed, informed consent obtained from the child's parents/legal guardian in accordance with current national legislation and good clinical practice (GCP) defined by the International Conference on Harmonization (ICH)

Exclusion Criteria:

• Ipratropium bromide received within four hours before admission
• First acute asthmatic attack
• Hospital admission to intensive care with asthma within six months before inclusion
• Hospital admission for asthma during the month prior to inclusion
• Corticosteroid-dependent asthma (oral corticosteroid therapy) or recently stopped corticosteroid therapy
• Concomitant cardiac disease
• Life threatening disease requiring immediate management; including: silent chest on auscultation, cyanosis, bradycardia less than 60 beats/min (bpm), confusion, coma
• Hypersensitivity to ipratropium bromide, salbutamol, or to any of their excipients
• Renal or hepatic insufficiency
• Poorly controlled diabetes
• Patients suffering from a disease considered to be severe by the investigator and which, in the opinion of the investigator, could interfere or invalidate the measurements performed in the trial
• Past history of lung surgery
• Major respiratory disease: pulmonary fibrosis, bronchiectasis, sarcoidosis, tuberculosis, respiratory disease due to AIDS, cystic fibrosis
• Patients unable to follow with protocol or correctly undergo the evaluations
• Patients who are taking part in another clinical trial during this trial or who have done so within the month before the trial
• Previous participation in this trial