Nebulised racemic adrenaline in the treatment of acute bronchiolitis in infants and toddlers.

Kristjánsson, Sigurður; Carlsen, K.C. Lødrup; Wennergren, Göran; Strannegård, Inga-Lisa; Carlsen, Kai‐Håkon

doi:10.1136/adc.69.6.650

Cited by 104 publications

(91 citation statements)

References 19 publications

(5 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Unlike other studies [1,18], this study did not see any significant difference in increase in heart rate in the two groups while there was a significant short term rise in HR in both groups after the intervention. There were no side effects of the bronchodilators used during the study which was similar to what was observed by other workers including those that did not find any benefit with the bronchodilators [1,19,20]. These findings are at variance to what has been mentioned in a recent multicentric trial which points to a lack of benefit of nebulized epinephrine in infants hospitalized with acute bronchiolitis , in either short-term or long-term clinically relevant outcomes [10].…”

Section: Discussioncontrasting

confidence: 56%

Comparision of Nebulised Salbutamol and L-epinephrine in First Time Wheezy Children

John¹,

Singh²

2010

Medical Journal Armed Forces India

View full text Add to dashboard Cite

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 (SpO 2 ), 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, SpO 2 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. MJAFI 2010; 66 : 9-13

show abstract

Section: Discussioncontrasting

confidence: 56%

Comparision of Nebulised Salbutamol and L-epinephrine in First Time Wheezy Children

John¹,

Singh²

2010

Medical Journal Armed Forces India

View full text Add to dashboard Cite

show abstract

“…of the existing research concerns LRTI, namely bronchiolitis, and are conducted in hospital settings (19 (9,20). Nevertheless, these scores have good psychometric characteristics, being related to gold standard measures, such as O2 saturation, so, they are often used, either in the clinical assessment, as in scienti ic investigation in children (9,10,21,22). However, as these scores evaluates the signs of respiratory distress, they cannot be used in mild cases of ARI or in community settings.…”

Section: Discussionmentioning

confidence: 99%

Subjective and objective parameters in paediatric respiratory conditions: cultural adaptation to Portuguese population

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In contrast, a later multicenter controlled trial by Wainwright et al 51 concluded that epinephrine did not impact the overall course of the illness as measured by hospital length of stay. Analysis of outpatient studies favors nebulized epinephrine over placebo in terms of clinical score, oxygen saturation, and respiratory rate at 60 minutes 57 and heart rate at 90 minutes. 58 However, the differences were small, and it could not be established that they are clinically significant in altering the course of the illness.…”

Section: Epinephrine/adrenalinementioning

confidence: 99%

“…47,52,53,57,58 It may be reasonable to administer a nebulized bronchodilator and evaluate clinical response. Individuals and institutions should assess the patient and document pretherapy and posttherapy changes using an objective means of evaluation.…”

Section: Epinephrine/adrenalinementioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

869

293

View full text Add to dashboard Cite

Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm.The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations.This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics.This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis. INTRODUCTIONTHIS GUIDELINE EXAMINES the published evidence on diagnosis and acute management of the child with bronchiolitis in both outpatient and hospital settings, including the roles of supportive therapy, oxygen, bronchodilators, antiinflammatory agents, antibacterial agents, and antiviral agents and make recommendations to influence clinician behavior on the basis of the evidence. Methods of prevention All clinical practice guidelines from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.The recommendations in this guideline do not indicate an exclusive course of treatment or serve as a standard of care. Variations, taking into account individual circumstances, may be appropriate. Key Word bronchiolitisAbbreviations CAM-complementary and alternative medicine LRTI-lower respiratory tract infection AHRQ-Agency for Healthcare Research and Quality RSV-respiratory syncytial virus AAP-American Academy of Pediatrics AAFP-American Academy...

show abstract

Nebulised racemic adrenaline in the treatment of acute bronchiolitis in infants and toddlers.

Abstract: The effect of inhaled nebulised racemic adrenaline upon symptoms of acute bronchiolitis was investigated in 29 infants and toddlers aged 2-17-5

Cited by 104 publications

References 19 publications

Comparision of Nebulised Salbutamol and L-epinephrine in First Time Wheezy Children

Comparision of Nebulised Salbutamol and L-epinephrine in First Time Wheezy Children

Subjective and objective parameters in paediatric respiratory conditions: cultural adaptation to Portuguese population

Diagnosis and Management of Bronchiolitis

Contact Info

Product

Resources

About