Comparaison de l'effet de l'injection sous-cutanée d'adrénaline et de terbutaline dans la crise d'asthme du nourrisson

Abstract

Edema of the mucous membranes lining the airways is a major factor of airway obstruction in asthma. Stimulation of both alpha and beta-adrenergic receptors is thus logically useful to reduce edema through vasoconstriction and to cause smooth muscle relaxation. The aim of this work was to compare the effects of subcutaneous epinephrine vs terbutaline for treating acute attack of asthma in infants. Fifty-four infants aged less than 30 months admitted for acute asthma attacks were included in this study. None had previous cardiovascular or definite pulmonary disease and none had tachycardia above 200/min. The patients were randomly given subcutaneous epinephrine, 10 micrograms/kg (n = 28) or subcutaneous terbutaline at the same dosage (n = 26). Improvement in accessory muscle use, oxygen saturation, PaO2 and PCO2 was similar in both groups. The respiratory rate was significantly improved after administration of epinephrine (P = 0.05). No adverse effects were seen in either drug. Subcutaneous administration of epinephrine is as effective as terbutaline in treating acute attack of asthma in infants. This drug, easy to use and of low-cost, could be the treatment of choice in developing countries.