Comparison of Efficacy of Nebulisation with Salbutamol versus Adrenaline in Acute Bronchiolitis in Children aged Two Months to Two Years

Abstract

Background: Bronchiolitis is an acute, highly communicable lower respiratory tract infection. A variety of agents ranging from nebulised racemic epinephrine, salbutamol and routinely available levoepinephrine have been tried. The Present study was aimed at comparing the effectiveness of adrenaline and salbutamol in acute bronchiolitis in children aged 2 months to 2 years.
 Materials and Methods: The Present study was conducted at Nobel medical College Teaching Hospital over the period of one year from Feb 2018 to Jan 2019. Two different cohorts were identified in which clinically diagnosed cases and were grouped into Group A and Group B to receive the different drugs as per the study protocol. Respiratory Distress Assessment Instrument (RDAI) Scores was used for clinical assessment.
 Results: The age of the patients ranged from 2 months to 24 months with a median of 8 months. The males constituting about 57.42% of the study population of 155 patients. On comparing the prenebulisation variables with 10 and 30 minutes post nebulisation values, it was found that Both adrenaline and salbutamol caused overall significant improvement in RR (p-value <0.00001 in both groups) except in the age group of 19-24 months. Adrenaline was seen to be superior to salbutamol in decreasing the RR (p<0.0001) except for children in the age group of 19-24months. Adrenaline also caused greater rise in heart rate in comparison to salbutamol in all age groups.
 Conclusion: This study concludes that Adrenaline was seen to be superior to salbutamol in decreasing the RR and RDAI, although it showed variance with age.

Comparison of Epinephrine and Salbutamol Nebulization in Acute Bronchiolitis in terms of mean change in RDAI Score

“…Another meta-analysis showed the effectiveness and superiority of epinephrine among outpatients in terms of improvement in respiratory rate and RDAI score with age variance. 6 Nada et al 10 conducted a study in Iraq to investigate the effect of epinephrine and salbutamol in the treatment of acute bronchiolitis in infants. In their findings, the mean SpO2 was significantly on a higher side in the epinephrine group (p=0.008) and there was also improvement in respiratory rate (p=0.003).…”

“…It was also helpful in reducing respiratory rate. 6 However, other studies did not reveal any significant difference between salbutamol and epinephrine in terms of symptomatic improvement. 7 So, the optimal treatment of bronchiolitis remains unclear.…”