Abstract
Background: Bronchiolitis is one of the most common respiratory diseases requiring hospitalization. Nebulized epinephrine and salbutamol therapy has been used in different centres with varying results. Objective: The objective of the study was to compare the efficacy of nebulised adrenaline diluted with 3% hypertonic saline with nebulised adrenaline diluted with normal saline in bronchiolitis. Methods: Fifty three infants and young children with bronchiolitis, age ranging from 2 months to 2 years, presenting in the emergency department of Manikganj Sadar Hospital were enrolled in the study. After initial evaluation, patients were randomized to receive either nebulized adrenaline I .5 ml ( 1.5 mg) diluted with 2 ml of3% hypertonic saline (group I) ornebulised adrenaline 1.5 ml (1.5 mg) diluted with 2 ml of normal saline (group II). Patients were evaluated again 30 minutes after nebulization. Results: Twenty eight patients in the group I (hypertonic saline) and twenty five in groupII (normal saline) were included in the study. After nebulization, mean respiratory rate decreased from 63.7 to 48.1 (p<.01), mean clinical severity score decreased from 8.5 to 3.5 (p<.01) and mean oxygen satw·ation increased 94.7% to 96.9% (p<.01) in group I. In group II, mean respiratory rate decreased from 62.4 to 47.4 (p<.01), mean clinical severity score decreased from 7.2 to 4.1 (p<.01) and mean oxygen saturation increased from 94. 7% to 96. 7% (p<.01). Mean respiratory rate decreased by 16 in group I versus 14.8 (p>.05) in group 11, mean clinical severity score decreased by 4.6 in group versus 3 (p<.05) in group, and mean oxygen saturation increased by 2.2% and 1.9% in group and group respectively. Difference in reduction in clinical severity score was statistically significant , though the changes in respiratory rate and oxygen saturation were not statistically significant. Conclusion: The study concluded that both nebulised adrenaline diluted with 3% hypertonic saline and nebulised adrenaline with normal saline are effective in improving respiratory rate, clinical severity score and oxygen saturation in infants with bronchiolitis; and nebulised adrenaline with hypertonic saline is more effective than nebulised adrenaline with normal saline in improving clinical severity score in bronchiolitis.
Highlights
Bronchiolitis is the inflammatory disease of the smallest airways and is the leading cause of respiratory distress of small children.r According to a recent survey, bronchiolitis is one of the common respiratory disorders in under five children in Bangladesh and comprises 2l% of all Address for Correspondence: Dr Laila Helaly Consultant, Bangladesh Thalassaemia Hospital Green Garden Tower, Level-6, 25 I A and 25 lB, Green Road, Dhaka-1205., Mobile : 0 I 7 1 1 1 5 I 5 70IBSMMU J 2014 ; 7 (t) : I5-I9J respiratory diseases.[2]
Fifty three previously healthy infants with bronchiolitis were enrolled in the study- 28 in the group I and 25 rn the group II
After nebulisation with adrenaline with 3% hypertonic saline, mean respiratory rate and mean clinical severity score decreased and mean oxygen safuration increased ; all respiratory parameter improved signific antly after nebulisation with hypertonic saline, but there was no difference in heart rute before and after nebulisation
Summary
Children with moderate and severe distress are hospitahzed.[3] Bronchodilator therapy is not recommended for routine use in- the maruagement of bronchiolitis. Review of a few studies shows that nebulised epinephrine has some potential for being efficacious.a. Bronchiolitis is one of the most common respiratory diseases requiring hospitalizalion. Objective: The objective of the study was to compare the efficacy of nebulised adrenaline diluted vu.t+h3% hypertonic saline with nebulised adrenaline diluted with normal saline in bronchiolitis. Patients were randomized,to receive either nebulized adrenaline 1.5 ml (1.5 mg) diluted with 2 ml of 3% hypertonic saline (group I) or nebulised adrenaline 1.5 ml (1.5 mg) diluted with 2 ml of normal saline (group II ). Results: Twenty eight patients in the group I (hypertonic saline) and twenty five in groupll (normal saline) were included in the study. Mean respiratory rate decreased from {3.7 to 48.1 (p
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