title: Emergency room management of acute bronchiolitis: a randomized trial of nebulized epinephrine.
abstract: Acute bronchiolitis is a common, potentially life-threatening condition with few therapeutic options. In the present randomized study, we compared the clinical efficacies of nebulized epinephrine and salbutamol in the emergency room management of acute bronchiolitis. Primary outcome measures were improvement in mean respiratory rate, mean oxygen saturation value and severity score. Secondary outcome measures were length of hospital stay, hospitalization and relapse rates. A total of 75 patients were analyzed (36 epinephrine, 39 salbutamol). Both groups experienced a similar pattern of clinical improvement. Hospitalization rates were 8.3% for epinephrine and 5.1% for salbutamol (p > 0.05), whereas relapse rates were 80% for epinephrine and 20% for salbutamol groups (p < 0.001). Respiratory syncytial virus was the most common virus identified (41%). We did not find a difference between salbutamol and epinephrine in terms of clinical improvement, but salbutamol can be a drug of choice due to its lower relapse and hospitalization rates compared to epinephrine.
authors.affiliation: Pediatric Pulmonology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Pelin Ozlem
authors.initials: PO
authors.lastname: Simşek-Kiper
authors.forename: Nural
authors.initials: N
authors.lastname: Kiper
authors.forename: Gülşen
authors.initials: G
authors.lastname: Hasçelik
authors.forename: Anil
authors.initials: A
authors.lastname: Dolgun
authors.forename: Ebru
authors.initials: E
authors.lastname: Yalçin
authors.forename: Deniz
authors.initials: D
authors.lastname: Doğru-Ersöz
authors.forename: Uğur
authors.initials: U
authors.lastname: Ozçelik
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000336:Aerosols; D000420:Albuterol / Q000008:administration & dosage; D001990:Bronchiolitis, Viral / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D010100:Oxygen / Q000097:blood; D056152:Respiratory Rate
chemical_list: D000336:Aerosols; D001993:Bronchodilator Agents; D000420:Albuterol; D010100:Oxygen; D004837:Epinephrine