Efficacy of albuterol in the management of bronchiolitis.
OBJECTIVE
To examine the efficacy of albuterol (0.15 mg/kg per dose) in the management of bronchiolitis.


METHODS
Randomized, double-blind, placebo-controlled outpatient clinical trial utilizing four study groups: neubulized albuterol, nebulized saline, oral albuterol, and oral placebo.


METHODS
Pediatric emergency department and outpatient clinic at University of Maryland in Baltimore.


METHODS
Eighty-eight infants (median age 5.5 months) being treated for their first episode of wheezing were randomly assigned to nebulized albuterol (n = 22), nebulized saline (n = 23), oral albuterol (n = 19), oral placebo (n = 24).


METHODS
The nebulized groups received two nebulizations 30 minutes apart, whereas the oral groups received one oral dose.


METHODS
Respiratory and heart rates, clinical score, oxygen saturation (Spo2), and the infant's state, ie, asleep, awake, or feeding, were recorded at baseline and at 30 and 60 minutes after treatment.


RESULTS
Randomization produced equivalent groups in terms of demographics and baseline measures. There were no statistically significant differences in any outcomes among the four treatments, except for oral albuterol, which produced an increase in heart rate (15 beats per minute, P = .005). No differences in the need for additional treatment or hospitalization were observed. Change in the state of the infant during the trial had significant effects on respiratory rate and clinical score.


CONCLUSIONS
Albuterol is as effective as oral placebo in the management of bronchiolitis. Past studies supporting the use of albuterol did not control for effects of change in state of the infant and did not use a truly inactive placebo group. This study underscores the importance of these design components in measuring the efficacy of albuterol in infants.
Gadomski
A M
AM
Division of General Pediatrics, University of Maryland, Baltimore.
Lichenstein
R
R
Horton
L
L
King
J
J
Keane
V
V
Permutt
T
T
D000280:Administration, Inhalation; D000284:Administration, Oral; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D001988:Bronchiolitis / Q000188:drug therapy* / Q000453:epidemiology; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007223:Infant; D008297:Male; D012119:Respiration / Q000187:drug effects
D000336:Aerosols; D000420:Albuterol