The Clinical Efficacy of Nebulized Racemic Epinephrine and Albuterol in Acute Bronchiolitis

Reijonen, Tiina M.; Korppi, Matti; Pitkäkangas, Sirpa; Tenhola, Sirpa; Remes, Kyllikki

doi:10.1001/archpedi.1995.02170190096017

Cited by 93 publications

(81 citation statements)

References 21 publications

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“…11 One trial used a crossover design; therefore, only data from the first phase were used in the meta-analysis. 13 This same study included 2 placebo groups; data from both groups were pooled. In some cases, variance was imputed from confidence intervals (CIs) 6,11,[13][14][15][16] and SEs.…”

Section: Data Extractionmentioning

confidence: 99%

“…13 This same study included 2 placebo groups; data from both groups were pooled. In some cases, variance was imputed from confidence intervals (CIs) 6,11,[13][14][15][16] and SEs. 14,17 To calculate the variance of change in oximetry in 1 study, the end time-point SDs were substituted with the baseline SDs.…”

Section: Data Extractionmentioning

confidence: 99%

“…It was used in 7 studies 6,[11][12][13][22][23][24] ; however, in 2 of these studies, scores were not reported. In 1 study, 24 the authors reported the mean time to a Respiratory Distress Assessment Instrument score of no greater than 4, and in another study 6 the authors reported only a P value for the mean change in score.…”

Section: Description Of Studiesmentioning

confidence: 99%

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A Meta-analysis of Randomized Controlled Trials Evaluating the Efficacy of Epinephrine for the Treatment of Acute Viral Bronchiolitis

Hartling¹,

Wiebe²,

Russell³

et al. 2003

Arch Pediatr Adolesc Med

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Section: Data Extractionmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

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A Meta-analysis of Randomized Controlled Trials Evaluating the Efficacy of Epinephrine for the Treatment of Acute Viral Bronchiolitis

Hartling¹,

Wiebe²,

Russell³

et al. 2003

Arch Pediatr Adolesc Med

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“…In a doubleblind randomized controlled trial (RCT) study, KRISTJÁ NSSON et al [15] demonstrated a small, but significant, improvement of oxygenation and symptom score by inhaled racemic adrenaline. In fact, there are four double-blind, RCT studies that report a better effect of inhaled adrenaline or racemic adrenaline, compared to salbutamol, in the treatment of acute bronchiolitis in infants [16][17][18][19]. In contrast, almost all placebo-controlled studies on the use of corticosteroids, given by systemic administration or inhalation, show no improvement in the clinical course of acute bronchiolitis [20][21][22][23][24].…”

mentioning

confidence: 99%

Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases

Wennergren¹,

Kristjánsson²

2001

Eur Respir J

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Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases. G. Wennergren, S. Kristjánsson. #ERS Journals Ltd 2001. ABSTRACT: Evidence from a large number of prospective case-control studies shows that respiratory syncytial virus (RSV) bronchiolitis in infancy is often associated with recurrent wheezing and asthma during subsequent years. However, wheezing tends to diminish and most studies show no significant increase in wheezing compared to controls by school age or adolescence. An unresolved question is whether severe RSV infection during infancy causes the respiratory sequelae or inherent abnormalities predispose an infant to develop severe respiratory infection and sequelae, i.e. RSV is associated with the development of pulmonary sequelae.Studies on long-term outcome of RSV bronchiolitis are reviewed from an evidencebased perspective.The majority of prospective placebo-controlled studies do not show any long-term beneficial effects of corticosteroid treatment, i.e. the risk of subsequent wheezing is not diminished by the treatment. The evidence for an increased risk of allergic sensitization after RSV bronchiolitis is not nearly as strong as the evidence for an increased risk of subsequent wheezing. In fact, most studies do not show any significant increase in atopy after RSV bronchiolitis. This suggests that the increased risk of wheezing after RSV is not linked to an increased risk of atopy. There are some indications that infants who develop severe RSV and subsequent wheezing may have aberrations that predate the RSV infection.To decide whether respiratory syncytial virus bronchiolitis causes, or is associated with the respiratory sequelae (or with subsequent allergy), it will be necessary to conduct prospective, randomized studies, where the cytokine profile prior to bronchiolitis onset is known. Such studies should preferably include some form of intervention against respiratory syncytial virus. A more complete understanding of the risk factors for severe respiratory syncytial virus infection and the role of respiratory syncytial virus infection in the initiation of asthma is needed as a basis for large-scale and cost-effective programmes to prevent respiratory syncytial virus-related morbidity. Eur Respir J 2001; 18: 1044-1058. Respiratory syncytial virus (RSV) bronchiolitis is the most common, severe lower respiratory tract infection in infancy. It now seems well established that RSV bronchiolitis in infancy is associated with recurrent wheezing and asthma during the first decade of life. In some children, wheezing after early lower airway infection with RSV is transient, but in many of the children RSV-induced bronchiolitis represents the onset of asthma. In fact, there are results which indicate that severe RSV bronchiolitis in the young infant may shift the T-helper (Th)1/Th2 balance in favour of a Th2 cytokine pattern, leading to development of allergic sensitization and persistent asthma [1,2]. However, the association with risk of development of atopy...

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“…Se esses pacientes viessem a fazer uso de doses maiores de drogas ß2 seletivas a resposta clínica não poderia ser semelhante? Por outro lado, alguns outros estudos não demonstraram um benefício clínico inequívoco do uso adrenalina, quando comparado a droga ß2 seletiva 32 .…”

Section: ß2 -Agonistasunclassified

Acute viral bronchiolitis - still subject for controversy

Amantéa¹,

Silva²

1998

J Pediatr (Rio J)

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ResumoObjetivos: Os autores apresentam uma revisão sobre bronquiolite viral aguda, salientando os aspectos, ainda controversos, relacionados à terapêutica da doença. Além dessas questões teóricas, referidas pela literatura, procuram estabelecer um juízo crítico acerca do assunto, referindo suas posições pessoais frente ao manejo dessa doença.Métodos: Foram selecionados, a partir de uma pesquisa no banco de dados da Medline, os artigos que julgamos mais significativos acerca do tema, publicados na literatura médica nos últimos 20 anos.Resultados: Bronquiolite viral aguda é a doença infecciosa do trato respiratório inferior mais freqüente no primeiro ano de idade. Apesar da sua significativa prevalência e de todo o risco que tal situação pode conferir aos pacientes nessa faixa etária, muito pouco evoluímos acerca da terapêutica empregada nessa situação clínica. Cada vez mais encontramos fundamentada a importância de uma hidratação adequada, dos cuidados necessários para prevenir infecção cruzada e da importância da oxigenoterapia. Muitas dúvidas persistem com relação ao papel das drogas broncodilatadoras e antivirais (ribavirina). Algumas perspectivas se abrem com o emprego de imunoglobulinas específicas, principalmente na prevenção da doença pelo vírus sincicial respiratório em populações de risco. Cada vez menos, encontramos justificada, a utilização de corticosteróides na fase aguda da doença.Conclusões: Bronquiolite viral aguda é uma doença que ainda carece de um tratamento ideal. As rotinas por nós empregadas pouco mudaram nos últimos 30 anos, o que faz com que haja muita controvérsia, acerca da terapêutica a ser utilizada entre os mais diversos centros de assistência.J. pediatr. (Rio J.). 1998; 74 (Supl.1): S37-S47: bronquiolite, vírus sincicial respiratório, ribavirina, broncodilatador. AbstractObjectives: The authors review the current literature on acute viral bronchiolitis discussing the points still subject to controversy in regard to its treatment. At the same time, a personal point of view on the management of this disorder based on the authors´ experience is also expressed.Methods: The main published papers from the last twenty years were selected from a Medline database search.

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The Clinical Efficacy of Nebulized Racemic Epinephrine and Albuterol in Acute Bronchiolitis

Cited by 93 publications

References 21 publications

A Meta-analysis of Randomized Controlled Trials Evaluating the Efficacy of Epinephrine for the Treatment of Acute Viral Bronchiolitis

A Meta-analysis of Randomized Controlled Trials Evaluating the Efficacy of Epinephrine for the Treatment of Acute Viral Bronchiolitis

Relationship between respiratory syncytial virus bronchiolitis and future obstructive airway diseases

Acute viral bronchiolitis - still subject for controversy

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