A Multicenter, Randomized, Double-Blind, Controlled Trial of Nebulized Epinephrine in Infants with Acute Bronchiolitis
| Autor: | Joyce Cheney, Marise Cheney, Sharon Sanders, Claire E. Wainwright, Nick Woolfield, Paul Francis, Scott Barber, Ann Kimberley, Dianne VandeVelde, Peter W.F. Wilson, Frank Fiumara, Susan Moloney, Steve Mego, Darrell Price, Peter O'Rourke, Luis Altamirano, Susan Cadzow |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Randomization Epinephrine Placebo law.invention Double-Blind Method Randomized controlled trial Heart Rate law Administration Inhalation Severity of illness Heart rate medicine Humans Racemic epinephrine business.industry Nebulizers and Vaporizers Oxygen Inhalation Therapy Infant General Medicine Length of Stay medicine.disease Bronchodilator Agents Hospitalization Blood pressure Bronchiolitis Anesthesia Acute Disease Female business medicine.drug |
| Zdroj: | New England Journal of Medicine. 349:27-35 |
| ISSN: | 1533-4406 0028-4793 |
| Popis: | background The treatment of infants with bronchiolitis is largely supportive. The role of bronchodilators is controversial. Most studies of the use of bronchodilators have enrolled small numbers of subjects and have examined only short-term outcomes, such as clinical scores. methods We conducted a randomized, double-blind, controlled trial comparing nebulized singleisomer epinephrine with placebo in 194 infants admitted to four hospitals in Queensland, Australia, with a clinical diagnosis of bronchiolitis. Three 4-ml doses of 1 percent nebulized epinephrine or three 4-ml doses of normal saline were administered at fourhour intervals after hospital admission. Observations were made at admission and just before, 30 minutes after, and 60 minutes after each dose. The primary outcome measures were the length of the hospital stay and the time until the infant was ready for discharge. The secondary outcome measures were the degree of change in the respiratory rate, the heart rate, and the respiratory-effort score and the time that supplemental oxygen was required. results There were no significant overall differences between the groups in the length of the hospital stay (P = 0.16) or the time until the infant was ready for discharge (P = 0.86). Among infants who required supplemental oxygen and intravenous fluids, the time until the infant was ready for discharge was significantly longer in the epinephrine group than in the placebo group (P=0.02). The need for supplemental oxygen at admission had the greatest influence on the score for severity of illness and strongly predicted the length of the hospital stay and the time until the infant was ready for discharge (P |
| Databáze: | OpenAIRE |
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