B M John1, D Singh2. 1. Classified Specialist (Paediatrics), Command Hospital (SC), Pune - 411040. 2. Senior Advisor (Paediatrics), Command Hospital (SC), Pune - 411040.
Abstract
BACKGROUND:Salbutamol is the standard recommendation in bronchial asthma. However, the use of bronchodilators in wheeze associated respiratory infections including bronchiolitis continues to be controversial. The aim of this study was to compare the efficacy of nebulised salbutamol versus epinephrine in 'first time' wheezy children using clinical parameters and airway resistance. METHODS:Sixty children between two months to 60 months were recruited, 30 in each treatment group. Children received periodic (0, 20, 40 minutes) doses of either salbutamol (0.15mg/kg with 3ml saline subject to a minimum of 2.5mg) or laevo- epinephrine (1:1000, 0.5ml/kg subject to a max of 2.5ml with 3ml saline) via nebuliser along with oxygen. Changes in heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR) and respiratory distress assessment instrument (RDAI) were assessed along with measurement of airway resistance using interrupter method (Hand held spirometer-Microloop with MicroRint module). RESULT: The respiratory status was better in the epinephrine group with significant improvement in RR, RDAI score, SpO2 and fall of airway resistance. There were no significant side effects noted in either group. CONCLUSION:Nebulised epinephrine is a useful and safe drug for wheezy children and is superior to salbutamol. This needs validation by large multicentric randomized blinded studies.
RCT Entities:
BACKGROUND:Salbutamol is the standard recommendation in bronchial asthma. However, the use of bronchodilators in wheeze associated respiratory infections including bronchiolitis continues to be controversial. The aim of this study was to compare the efficacy of nebulised salbutamol versus epinephrine in 'first time' wheezy children using clinical parameters and airway resistance. METHODS: Sixty children between two months to 60 months were recruited, 30 in each treatment group. Children received periodic (0, 20, 40 minutes) doses of either salbutamol (0.15mg/kg with 3ml saline subject to a minimum of 2.5mg) or laevo- epinephrine (1:1000, 0.5ml/kg subject to a max of 2.5ml with 3ml saline) via nebuliser along with oxygen. Changes in heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR) and respiratory distress assessment instrument (RDAI) were assessed along with measurement of airway resistance using interrupter method (Hand held spirometer-Microloop with MicroRint module). RESULT: The respiratory status was better in the epinephrine group with significant improvement in RR, RDAI score, SpO2 and fall of airway resistance. There were no significant side effects noted in either group. CONCLUSION: Nebulised epinephrine is a useful and safe drug for wheezy children and is superior to salbutamol. This needs validation by large multicentric randomized blinded studies.
Entities:
Keywords:
Epinephrine; Nebulised bronchodilators; Salbutamol; Wheezy children
Authors: E E Wang; B J Law; F D Boucher; D Stephens; J L Robinson; S Dobson; J M Langley; J McDonald; N E MacDonald; I Mitchell Journal: J Pediatr Date: 1996-09 Impact factor: 4.406