Role of Nebulized Epinephrine in Moderate Bronchiolitis: A Quasirandomized Trial - Abstract
Bronchiolitis is the most common lower respiratory illness that characteristically affects the children below two years of age accounting about 2-3% of patients, admitted to hospital each year. We compared the effect of Racemic Epinephrine (RE) and 3% Hypertonic saline (HS) nebulization on the length of stay (LOS) in the hospital. We looked at the infants with moderate bronchiolitis, from October 2013 through March 2014. Out of eighty cases, 16 in HS and 18 in RE groups were enrolled.
At the time of admission, 0.2ml of RE added to 1.8ml of distilled water was nebulized to RE group, as compared to 2ml of 3% HS in nebulized form. RE was readministered if needed on 6 hourly in comparison to 3% HS at the frequency of 1 to 4 hourly. One infant from RE group and three infants from HS group were excluded due to progression towards severe bronchiolitis. The LOS in RE group ranged between 18-160 hrs (Mean 45 hrs) while in HS group, LOS was 18.50- 206 hrs (Mean 74.3 hrs). The LOS was significantly short in RE group (p-value 0.015) which was statistically significant. Racemic Epinephrine nebulization as first-line medication may significantly reduce the length of hospital stay in infants with moderate bronchiolitis in comparison to nebulized HS.