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No Significant Advantage Demonstrated Between Nebulised Albuterol and Racemic Epinephrine in Treatment of Infant Bronchiolitis: Presented at AAP

By Maria Bishop
Special to DG News

BOSTON, MA -- October 21, 2002 -- Researchers from California could demonstrate no significant advantage between albuterol and racemic epinephrine in a group of infants with bronchiolitis.

These findings were presented here October 20 at a poster session on paediatric critical care at the annual meeting of the American Academy of Pediatrics (AAP).

Albuterol and racemic epinephrine are standard therapies for bronchiolitis, stated Dr. Ilana Amos, a paediatrician at White Memorial Medical Center, in Los Angeles, California, United States. Evidence that either drug could sustain a clinical advantage over the other would significantly alter management.

The study, conducted at both White Memorial and Loma Linda University Medical Centers, undertook a prospective, double blind study of 36 infants aged one year or less, with a diagnosis of bronchiolitis. All infants were enrolled between February and April of 2002 from the paediatric intensive care units (PICUs) and the paediatric wards. Infants in the PICU required continuous monitoring which was not available on the wards.

There was no significant difference between the initial respiratory distress scores of the patients in the PICUs or the ward patients, and their data was pooled. Patients under 32 weeks gestational age, those requiring mechanical ventilation, and those with chronic lung disease, congenital heart disease or an immune disorder were excluded from the study.

Twenty-six enrolled patients met the criteria and completed the study. Of these, 13 received racemic epinephrine and 13 received nebulised albuterol. The researchers conducted the statistical analysis by t-test. They saw no significant difference between the two groups in total hospital length of stay; oxygen duration; number of treatments; or the PICU length of stay (where applicable).

Previous studies showed that racemic epinephrine in the short term decreased the respiratory rate and was more effective in improving respiratory distress scores than were selective beta-2 bronchodilators.

This study, however, did not show that racemic epinephrine sustained its early advantage, Dr. Amos said.

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