Randomized controlled trial of nebulized adrenaline in acute bronchiolitis.
Use of both l-epinephrine and racemic epinephrine (adrenaline) has improved clinical symptoms and composite respiratory scores in acute bronchiolitis. The objective of this randomized double-blind placebo-controlled study was to assess whether there was sufficient improvement in clinical state to reduce hospital admissions. Seventy-five infants aged 1 month to 1 year with a clinical diagnosis of acute bronchiolitis were treated with either 2 ml of 1:1000 nebulized adrenaline or 2 ml of nebulized normal saline administered after baseline assessment and 30 min later. Clinical respiratory parameters were recorded at 15-min intervals for a period of 2 h following the baseline assessment. Admission to hospital was the primary end-point and changes in respiratory parameters were secondary end-points. Fifty percent (19/38) of infants treated with adrenaline were discharged home compared with 38 percent (14/37) of those treated with saline. This 12 percent reduction in rate of admission is not statistically significant (95% CI of difference: -10% to 35%). There was no difference between treated and placebo groups in respiratory rate, oxygen saturation, heart rate or a composite respiratory distress score at 30, 60 or 120 min post-treatment. In this study, nebulized epinephrine did not confer a significant advantage over nebulized saline in the emergency room treatment of acute bronchiolitis.
Hariprakash
Suriyanarayanapillai
S
Department of Paediatrics, North Staffordshire Hospital NHS Trust, Stoke-on-Trent, United Kingdom.
Alexander
John
J
Carroll
Will
W
Ramesh
Pavanasam
P
Randell
Tabitha
T
Turnbull
Frances
F
Lenney
Warren
W
D000208:Acute Disease; D000280:Administration, Inhalation; D001988:Bronchiolitis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000008:administration & dosage*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D009330:Nebulizers and Vaporizers; D064705:Racepinephrine; D012965:Sodium Chloride / Q000008:administration & dosage*; D006113:United Kingdom
D001993:Bronchodilator Agents; D012965:Sodium Chloride; D064705:Racepinephrine; D004837:Epinephrine