Salbutamol or mist in acute bronchiolitis

Abstract

Background: The role of bronchodilators in the treatment of bronchiolitis remains controversial. M e t M : A double-blind, placebo controlled trial was performed to evaluate the clinical response to nebulized salbutamol. One hundred and fifty-six infants aged between 7 weeks and 24 months who had had an episode of wheezing and other signs and symptoms of bronchiolitis were randomized to three groups as follows: (i) nebulized salbutamol was administered to 52 patients in group I at a dose of 0.15 mgkg in 2 mL saline: (ii) saline was nebulized to 52 patients in group I1 and (iii) in group 111 52 patients received mist in a tent. All three groups were administered oxygen during the procedures. Treatment was repeated with the same agent after 30 min if the respiratory score was 5 or more. Respiratory rate, heart rate, oxygen saturation and presence of cyanosis, wheezing, retractions were recorded before and after each treatment. Results:The decrease in the respiratory score was 5.2 * 1.8, 0.82 * 2.4 and 1.7 1.3 in group I, I1 and 111, respectively. The decrease in group I was significantly higher than in the other groups. Heart rate was similar between groups. Oxygen saturation decreased in group I without reaching statistical significance. Comluswns:Salbutamol was shown to be effective and safe in the treatment of acute bronchiolitis. , 1 8 October 1997. recorded. A second dose of each-medication was given to Salbutamol in bronchiolitis 253 patients with a RDS greater than 5 at 30 min. Heart rate, S,o, and RDS were recorded again at the end of the first hour and the study was completed. Statistical analysis was performed by Student's t-test, Chi-squared and ANOVA analysis.

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“…In three of these studies, some difference had been observed [3,11,12], yet it resulted in only a small transient improvement in the acute clinical score and had no effect on hospital admission rates or duration of stay in hospital. In one of these three studies [11], ex-premature infants who might have had some mild underlying chronic lung disease, which might have resulted in the response to bronchodilators, were not excluded.…”

“…In one of these three studies [11], ex-premature infants who might have had some mild underlying chronic lung disease, which might have resulted in the response to bronchodilators, were not excluded. Several studies reported an increase in heart rate [12] or a decrease in oxygen saturation [3] after salbutamol or albuterol.…”

“…They found that the wheeze score and the pulmonary function tests were not significantly affected by albuterol. This is the latest of 12 randomised controlled trials in 12 years [2,3,4,5,6,7,8,9,10,11,12], involving 843 infants, that evaluated the effect of bronchodilators on bronchiolitis. After so many trials, have we resolved whether bronchodilators have a role in the management of bronchiolitis, and have pulmonary function measurements been helpful?…”

Comparison of Nebulized Epinephrine to Albuterol in Bronchiolitis

“…Although commonly used, 5 its efficacy is not universally accepted. Small studies 6–9 and systematic reviews have shown small, short‐term improvement in clinical scores in outpatient use of albuterol 10 . There is, however, no convincing evidence that albuterol decreases the admission rate in outpatients 10 .…”

Diagnosis and Testing in Bronchiolitis

“…Seventeen studies obtained chest x-ray films on all patients (Table 5), 7,12,19,20,28,[30][31][32][33][34][35][36][37][38][39][40][41] but many clinical trials do not report chest x-ray film results. Two studies examined the relationship between x-ray film abnormalities and disease severity.…”