Murphy K, Mahmood N, Craven D, et al. - Researchers determined the impact of inhaled ipratropium on clinical outcomes of critical asthma in the first randomized trial of this adjunctive therapy in critically ill children. Thirty children (15/group) with critical asthma receiving high‐intensity albuterol per a standardized pathway using objective tests to wean patients to less regular administration of albuterol. Study participants were randomized to obtain either nebulized ipratropium bromide (500 µg in 0.9% saline per dose) or an equivalent volume of nebulized 0.9% saline every 6 hours until the patient was successfully weaned to albuterol doses every 2 hours (“q2 albuterol”). Demographics, initial clinical severity score, and asthma histories were comparable between groups. According to this pilot, placebo‐controlled, double blinded, randomized controlled trial, compared with placebo, adjunctive therapy with ipratropium was not related to reduced duration of high intensity albuterol or shortened length of stay.