The Efficacy of Nebulized Metaproterenol in Wheezing Infants and Young Children

Alario, Anthony J.; Lewander, William J.; Dennehy, Penelope H.; Seifer, Ronald; Mansell, Anthony L.

doi:10.1001/archpedi.1992.02160160032008

Cited by 32 publications

(27 citation statements)

References 32 publications

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“…Several meta-analyses and systematic reviews [48][49][50][51][52][53] [57][58][59] are methodologically weaker than other studies and include older children with recurrent wheezing. Results of the Cochrane review indicated no benefit in the clinical course of infants with bronchiolitis who received bronchodilators.…”

Section: Action Statement Profile Kasmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,404

1,654

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This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows:

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Section: Action Statement Profile Kasmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,404

1,654

View full text Add to dashboard Cite

show abstract

“…A Cochrane systematic review 44 found 8 RCTs involving 394 children. 33,[45][46][47][48][49][50] Some of the studies included infants who had a history of previous wheezing. Several used agents other than albuterol/salbutamol or epinephrine/adrenaline (eg, ipratropium and metaproterenol).…”

Section: Recommendation 2b a Carefully Monitored Trial Of ␣-Adrenergimentioning

confidence: 99%

“…Individuals and institutions should assess the patient and document pretherapy and posttherapy changes using an objective means of evaluation. Some of the documentation tools that have been used can be found in articles by Alario et al, 45 Bierman and Pierson, 63 Gadomski et al, 54 Lowell et al, 33 Wainwright et al, 51 Schuh et al, 64 and Gorelick et al 65 In addition, a documentation tool has been developed by Cincinnati Children's Hospital (Cincinnati, OH). 66 Extrapolation from the studies discussed above suggests that epinephrine may be the preferred bronchodilator for this trial in the emergency department and in hospitalized patients.…”

Section: Epinephrine/adrenalinementioning

confidence: 99%

Diagnosis and Management of Bronchiolitis

2006

Pediatrics

883

293

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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...

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“…Allario e cols. 24 concluíram que o sulfato de metaproterenol foi efetivo na reversão da angústia respiratória, apresentando uma resposta variável de acordo com idade da criança, sendo mais pronunciada em crianças mais jovens -12 meses ou menos -com infecção pelo VSR. Recentemente, Derisch e cols.…”

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 Efficacy of Nebulized Metaproterenol in Wheezing Infants and Young Children

Cited by 32 publications

References 32 publications

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Diagnosis and Management of Bronchiolitis

Acute viral bronchiolitis - still subject for controversy

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