Tags

Type your tag names separated by a space and hit enter

A randomized trial of nebulized epinephrine vs albuterol in the emergency department treatment of bronchiolitis.
Arch Pediatr Adolesc Med. 2004 Feb; 158(2):113-8.AP

Abstract

OBJECTIVE

To determine if nebulized epinephrine is more efficacious than nebulized albuterol in the emergency department (ED) treatment of moderately ill infants with bronchiolitis.

METHODS

Sixty-six patients between 0 and 12 months of age with new-onset wheezing, an antecedent upper respiratory tract infection, and a clinical score (Respiratory Distress Assessment Instrument) of 8 to 15 were randomized in a double-blind fashion to receive either 0.9 mg/kg of nebulized 2.25% racemic epinephrine (n = 34) or 0.15 mg/kg of nebulized 0.5% albuterol sulfate (n = 32) at 0, 30, and 60 minutes.

MAIN OUTCOME MEASURES

Primary outcome measures were clinical score and respiratory rate. Secondary outcome measures were room air oxygen saturation, elapsed time to meeting clinical criteria for ED discharge, hospitalization rate, and proportion of patients relapsed within 72 hours of ED discharge (relapse rate).

RESULTS

Both treatment groups experienced a similar pattern of change in mean clinical score, respiratory rate, and room air saturation over time. There were no significant differences between the groups by these same measures at any time. The median time at which infants were well enough for ED discharge was 90 minutes in the epinephrine-treated group vs 120 minutes in the albuterol-treated group (P =.01). Sixteen infants (47.1%) in the epinephrine-treated group were hospitalized compared with 12 infants (37.5%) in the albuterol-treated group (relative risk, 1.25; 95% confidence interval, 0.71-2.22). Relapse rate was 18.8% (3/16) in the epinephrine-treated group and 42.1% (8/19) in the albuterol-treated group (relative risk, 0.45; 95% confidence interval, 0.14-1.41). Adverse effects occurred infrequently.

CONCLUSIONS

Although the patients treated with epinephrine were judged well enough for ED discharge significantly earlier than the patients treated with albuterol, epinephrine was not found to be more efficacious than albuterol in treating moderately ill infants with bronchiolitis.

Authors+Show Affiliations

Division of Emergency Medicine, Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19899, USA. cmull@nemours.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14757602

Citation

Mull, Colette C., et al. "A Randomized Trial of Nebulized Epinephrine Vs Albuterol in the Emergency Department Treatment of Bronchiolitis." Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 2, 2004, pp. 113-8.
Mull CC, Scarfone RJ, Ferri LR, et al. A randomized trial of nebulized epinephrine vs albuterol in the emergency department treatment of bronchiolitis. Arch Pediatr Adolesc Med. 2004;158(2):113-8.
Mull, C. C., Scarfone, R. J., Ferri, L. R., Carlin, T., Salvaggio, C., Bechtel, K. A., Trephan, M. A., Rissman, R. L., & Gracely, E. J. (2004). A randomized trial of nebulized epinephrine vs albuterol in the emergency department treatment of bronchiolitis. Archives of Pediatrics & Adolescent Medicine, 158(2), 113-8.
Mull CC, et al. A Randomized Trial of Nebulized Epinephrine Vs Albuterol in the Emergency Department Treatment of Bronchiolitis. Arch Pediatr Adolesc Med. 2004;158(2):113-8. PubMed PMID: 14757602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of nebulized epinephrine vs albuterol in the emergency department treatment of bronchiolitis. AU - Mull,Colette C, AU - Scarfone,Richard J, AU - Ferri,Lara R, AU - Carlin,Teresa, AU - Salvaggio,Christy, AU - Bechtel,Kirsten A, AU - Trephan,Mary Ann Hanes, AU - Rissman,Raquel L, AU - Gracely,Edward J, PY - 2004/2/6/pubmed PY - 2004/3/12/medline PY - 2004/2/6/entrez SP - 113 EP - 8 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 158 IS - 2 N2 - OBJECTIVE: To determine if nebulized epinephrine is more efficacious than nebulized albuterol in the emergency department (ED) treatment of moderately ill infants with bronchiolitis. METHODS: Sixty-six patients between 0 and 12 months of age with new-onset wheezing, an antecedent upper respiratory tract infection, and a clinical score (Respiratory Distress Assessment Instrument) of 8 to 15 were randomized in a double-blind fashion to receive either 0.9 mg/kg of nebulized 2.25% racemic epinephrine (n = 34) or 0.15 mg/kg of nebulized 0.5% albuterol sulfate (n = 32) at 0, 30, and 60 minutes. MAIN OUTCOME MEASURES: Primary outcome measures were clinical score and respiratory rate. Secondary outcome measures were room air oxygen saturation, elapsed time to meeting clinical criteria for ED discharge, hospitalization rate, and proportion of patients relapsed within 72 hours of ED discharge (relapse rate). RESULTS: Both treatment groups experienced a similar pattern of change in mean clinical score, respiratory rate, and room air saturation over time. There were no significant differences between the groups by these same measures at any time. The median time at which infants were well enough for ED discharge was 90 minutes in the epinephrine-treated group vs 120 minutes in the albuterol-treated group (P =.01). Sixteen infants (47.1%) in the epinephrine-treated group were hospitalized compared with 12 infants (37.5%) in the albuterol-treated group (relative risk, 1.25; 95% confidence interval, 0.71-2.22). Relapse rate was 18.8% (3/16) in the epinephrine-treated group and 42.1% (8/19) in the albuterol-treated group (relative risk, 0.45; 95% confidence interval, 0.14-1.41). Adverse effects occurred infrequently. CONCLUSIONS: Although the patients treated with epinephrine were judged well enough for ED discharge significantly earlier than the patients treated with albuterol, epinephrine was not found to be more efficacious than albuterol in treating moderately ill infants with bronchiolitis. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/14757602/A_randomized_trial_of_nebulized_epinephrine_vs_albuterol_in_the_emergency_department_treatment_of_bronchiolitis_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.158.2.113 DB - PRIME DP - Unbound Medicine ER -