Salbutamol Group Research Articles

Magnesium Sulphate (MgSO4) Nebulization versus Salbutamol Nebulization in Acute Asthmatic Attacks in Adults

Background: Short acting s2-agonist is considered the main stay of therapy in acute asthma episodes, but it could not completely relieve the bronchospasm and reduce dyspnea. One of the other treatments is magnesium sulphate (MgSO4). Nebulized MgSO4 effect has been less evaluated in asthmatics. Aim of the Work is to compare the effects of nebulized MgSO4 in higher doses versus salbutamol nebulization in severe asthmatic attacks. Patients and Methods: Two hundreds asthmatic patients with severe attacks were included in an interventional study. Following initial clinical evaluation and spirometric measurements especially peak expiratory flow (PEF) and Forced expiratory volume in the first second (FEV1) measurements (after control), patients were divided into two equal groups; group I: nebulized salbutamol and group II: nebulized MgSO4. Salbutamol group received salbutamol (2.5 ml)+saline (2.5 ml) while MgSO4 group received MgSO4 (500mg), 7.5 ml (2 mmol vial), through a jet nebulizer. The nebulizations were given 3 times for the first hour, 20 minutes apart, then hydrocortisone and oxygen if not improved then every hour for the remaining 4 hours. Clinical reevaluation, PEF and FEV1 remeasurement were done. Results: The pre-nebulizer clinical parameters, PEF and FEV1 were nearly similar between groups I and II: (PEF: 376.45±49.88 versus 388.46±43.22, respectively), (FEV1: 57.06±9.03 versus 56.51±9.18, respectively). The post-nebulizer PEF and FEV1 values between groups I and II were also nearly similar: (PEF: 410.98±273.82 versus 391.24±39.81, respectively, with p value 0.47), (FEV1: 62.22±9.52 versus 61.78±9.41, respectively, with p value 0.74); indicating the nearly equal effectiveness of both medications. However, the clinical parameters post-nebulization were different: group I developed tachycardia, palpitation and tremors as side effects while group II side effects included nausea, taste changes, numbness and dizziness. Conclusion: Nebulized magnesium sulphate provides nearly equal response as compared to salbutamol in the treatment of acute asthmatic attacks in adults.

Nebulized heparin and salbutamol versus salbutamol alone in acute exacerbations of chronic obstructive pulmonary disease requiring mechanical ventilation: a double-blind randomized controlled trial.

BackgroundNebulized heparin has been effectively used in the management of many pulmonary diseases. However, its effect on mechanically ventilated patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD) has never been studied. This study aimed to assess the efficacy of nebulized heparin and salbutamol to increase ventilator-free days (VFD) in mechanically ventilated AECOPD patients and the effect of nebulized heparin on respiratory and coagulation functions.MethodsIn this double-blind controlled study, 60 mechanically ventilated adult patients with AECOPD were randomly allocated into two groups; heparin and salbutamol (HS) group and salbutamol only (S) group. In the Group HS, patients received nebulized heparin (25,000 IU) and salbutamol (5 mg) every 6 hours. Patients in the Group S received nebulized salbutamol only (5 mg). The treatment was continued while patients remained ventilated for a maximum of 14 days. The primary outcome was VFDs at day 14. PaCO2, PaO2/FiO2 ratio, number of nebulizations withheld, C-reactive protein (CRP) titer and activated partial thromboplastin time (APTT) were secondary outcomes.ResultsPatients in the Group HS had significantly more VFDs (4.7 ± 3.3) compared with those in the Group S (2.4 ± 2.6), P = 0.007. PaCO2 levels, PaO2/FiO2, the decrease in the CRP level and the increase in the APTT from the baseline showed no evidence of difference in both groups.ConclusionsThe co-administration of nebulized heparin and salbutamol, compared with salbutamol alone, significantly increased (VFDs) among mechanically ventilated AECOPD patients without increasing bleeding risks.

Evaluation of inhaled beta-2 agonist in management of transient tachypnea of the newborn

BackgroundTransient tachypnea of the newborn (TTN) is a common cause of early neonatal respiratory distress. It is due to delayed clearance of fetal lung fluid.AimTo evaluate the effect of inhaled salbutamol, a beta-2 adrenergic agonist (β2AA), in management of TTN and to detect any side effects as a result of using itMethodsA total of 100 infants with TTN were randomly divided into two groups to receive either inhaled salbutamol (treatment group) or an equal volume of normal saline solution (placebo group) at the time of diagnosis. At enrollment (by the 6th hour), complete blood count, blood glucose, serum potassium (K+), arterial blood gasses, respiratory rate, heart rate, blood oxygen saturation (O2 Sat), fraction of inspired oxygen (FiO2), and TTN clinical score were determined for all patients. At 0.5, 1, and 4 h after drug administration, respiratory rate, heart rate, O2 Sat, FiO2, and the clinical TTN score were recorded. At 4 h after treatment, arterial blood gasses, serum K+, and blood glucose levels were measured again. The duration of total respiratory support and the duration of hospitalization were recorded as well.ResultsNo statistically significant differences existed between both groups in terms of gestational age, birth weight, gender, mode of delivery, Apgar score, or maternal risk factors. The duration of respiratory support and duration of hospitalization were significantly shorter in the treatment (salbutamol) group (P < 0.0005, P < 0.0002, respectively). In the treatment (salbutamol) group; the respiratory rate, FiO2 and TTN score were significantly lower after treatment (P < 0.0001, P < 0.0000, P < 0.0000, respectively). Also the PaO2 significantly increased (P < 0.0000) with significant improvement in PH (P < 0.0001) and significant reduction in PaCO2 (P < 0.03). However, there were no statistically significant differences in heart rates, serum K+, or glucose levels after treatment.ConclusionInhaled salbutamol, a β2AA, was effective in reducing the duration of respiratory support and hospitalization in TTN, with no detected side effects.

Differences of Respiratory Rate Between Salbutamol and Aminofilin in Exacerbation Asthma

Exacerbation of asthma is a progressive step in progressive breathing, coughing, wheezing, breathing. In Indonesia salbutamol nebulation is used for the therapy of the first exacerbation attack. In addition, intravenous aminophylline is also recommended as a therapy, even if the use of aminophylline abroad is reduced due to its smaller effectiveness and often leads to greater unwanted reaction events. The effectiveness of asthma exacerbation therapy needs to be monitored and one of the monitoring parameters that is easily seen is the rate of breath.The aim of this study was to investigate the difference in respiratory rate values using salbutamol nebulisation and intravenous aminophylline in patients with asthma exacerbations in hospitals in Surabaya. The research was conducted by using quasi experimental method and data collection by purposive sampling. Analysis of the data to be used is a independent t-test. The results showed that the salbutamol group decreased respiratory rate by 50.00%, there were also patients who experienced an increase of breath rate of 13.64%. In the aminophylline group experienced a decrease in respiratory rate of 43.75% with an increase of breath rate of 18.75%. From the results of the study, it is necessary to monitor the effectiveness and the need to monitor the unwanted reactions of both treatments so that the therapies produced in the treatment of asthma exacerbations are more effective.Key words: Aminophylline, exacerbation asthma, respiratory rate, salbutamol

Comparison of Adrenaline and Salbutamol nebulization in treatment of Children with Bronchiolitis.

Background: Bronchiolitis is an acute inflammation of bronchioles that can be severe enough to require admission in intensive care unit. There are multiple modalities used for treatment of bronchiolitis. The objective of this study was to compare the response of adrenaline and salbutamol nebulization in terms of clinical improvement and duration of hospital stay. Study Design: Randomized controlled trial. Setting: Pediatrics Department of Avicenna Medical College and Hospital, Lahore. Period: March 2018 to October 2018. Methods: Total 66 patients with 33 in each group between ages of 2-months to 3-years admitted with the diagnosis of bronchiolitis, were included in the study. Children in the group 1 were patients treated with salbutamol nebulization 0.15 mg/kg with 3 ml normal saline every six hourly. Children in the group 2 received adrenaline nebulization 0.1 ml/kg of 1:1000 dilutions with 3 ml normal saline every six hourly. Both the groups were given similar supportive management that included oxygen therapy, intravenous fluids, and antipyretics. Data was collected in the form of age, gender, heart rate, respiratory rate, SpO2 and RDAI score at admission, 6hr, 24 hr and 48hr after admission, duration of hospital stay and duration of oxygen therapy. Results: Out of 66 patients, 38(57.6%) were male and 28(42%) were female. The mean with standard deviation of age in months was 20.45 + 12.9 in salbutamol group and 16.7 + 12.3 in adrenaline group (p value = 0.23). Mean with standard deviation of weight of patients was 9.7+ 3.5 in salbutamol group and 8.9+3.3 in adrenaline group (p value =0.34). Regarding the duration of hospital stay the mean and standard deviation of hospital stay was 4.2+ 0.9 in salbutamol group and 3.9 + 1 in adrenaline group with p value 0.016. Mean and standard deviation of duration of oxygen therapy was 1.05+ 0.7 in salbutamol group and 0.9+0.4 in adrenaline group with p value 0.42. There was no significant difference in the values of RDAI, heart rate, respiratory rate, SPO2 at admission and subsequently after 6hrs, 24hrs, and 48hrs. Conclusion: We concluded that there was a significant reduction in duration of hospital stay in patients who received adrenaline nebulization then those nebulized with salbutamol. RDAI scores in the initial 48 hours in both the groups were improved in successive readings, but there was no significant difference in RDAI scores between the two groups recorded at different time intervals.

Comparative Efficacy of Nebulized 7% Hypertonic Saline versus 0.9% Normal Saline with Salbutamol in Children with Acute Bronchiolitis

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection of infants and is the leading cause of hospitalization of infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 0.9% normal saline with salbutamol and 3% hypertonic saline has been found effective. This study was undertaken to assess the efficacy of 7% hypertonic saline on recovery from acute bronchiolitis.&#x0D; Methodology: This was a randomized controlled trial, carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Bangladesh between January 2015 to December 2015. A total of 90 children from 1 month to 2 years of age of either sex who were diagnosed and admitted as acute bronchiolitis were enrolled. After enrollment, they were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 0.9% nebulized normal saline with salbutamol (Group-II = 45). The efficacy was determined by assessing clinical severity score and length of hospital stay. Data were analyzed using computer software SPSS version 19.&#x0D; Result: In this study the two groups were almost similar with respect to their demographic and baseline clinical severity score. After intervention the clinical severity score of both treatment modalities were reduced (Group-I(HS) were 7.9, 6.8, 3.8, 1.4, 1.33 while in Group-II(NS+ Salbutamol) score were 8.6, 7.6, 4.9, 3.11, 2.12) but the reduction was significant more in children who received 7% nebulized hypertonic saline than those who received 0.9% nebulized normal saline with salbutamol. Majority 42(93.3%) of group-I(HS) children recovered at the end of 72 hours whereas 17(37.8%) of the children of group-II (NS+ Salbutamol) recovered from the disease during the same period. Length of hospital stay was shorter in hypertonic saline group compared to normal saline with salbutamol group (56.36±12.33 hours vs71.07±13.48 hours, p&lt;.001). The patients of hypertonic saline group required a shorter duration of oxygen therapy compared to normal saline with salbutamol group (12.53±3.58) hours vs (20.25± 4.15) hours, (p=0.009).&#x0D; Conclusion: 7% hypertonic saline was found more effective than 0.9% normal saline with salbutamol in terms of reducing clinical severity, length of hospital stays and duration of oxygen therapy.&#x0D; Bangladesh J Child Health 2019; VOL 43 (2) :80-84

A budget impact analysis of budesonide/formoterol in patients with mild asthma in Egypt

Background: The aim of this study is to estimate the budget impact of budesonide/formoterol fixed dose combination (FDC) vs salbutamol, both used as needed, in mild asthma patients, from the perspective of the Health Insurance Organization (HIO).Methods: A static budget impact model was developed to assess the impact of budesonide/formoterol FDC entry on HIO budget over a 3-year period in Egyptian settings. Direct medical costs, including the costs of asthma medications, exacerbations, and management of side-effects, were obtained from HIO cost data. Population data were obtained from the World Bank and supplemented with local studies, and the rates of exacerbations, adverse effects, and number of sick leave days were elicited from the SYGMA 1 trial. Scenario analyses from a societal perspective and deterministic sensitivity analyses were conducted.Results: The total costs (drug and non-drug costs) for managing mild asthma patients from the HIO perspective were estimated to be EGP8.563 billion before budesonide/formoterol entry compared to EGP5.525 billion post-entry, leading to a total budget savings of EGP3.038 billion after 3 years. This total budget saving included an increase in drug costs (EGP104 million) and a decrease in non-drug costs (EGP3.143 billion). Drug costs were higher in the budesonide/formoterol group than in the salbutamol group, but this cost was offset by reductions in non-drug costs, resulting in a reduction in the total costs of healthcare resources. At the societal level, the total budget savings after including the indirect costs was expected to be EGP5.976 billion after 3 years of budesonide/formoterol entry.Conclusion: Budesonide/formoterol in mild asthma instead of salbutamol produces better patient outcomes and decreases total costs, with increases in drug cost offset by reductions in non-drug costs due to fewer exacerbations. Budesonide/formoterol is a budget saving option for guideline-directed treatment, from the economic perspective of the payer and the health perspective of the patient.

Low-dose l-isoproterenol versus salbutamol in hospitalized pediatric patients with severe acute exacerbation of asthma: A double-blind, randomized controlled trial

BackgroundAlthough the guidelines in most countries do not recommend continuous inhalation of l-isoproterenol to treat pediatric patients with acute severe exacerbation of asthma, lower dose of l-isoproterenol has been widely used in Japan. To determine whether the efficacy of low-dose l-isoproterenol was superior to that of salbutamol, we conducted a double-blind, randomized controlled trial. MethodsHospitalized patients aged 1–17 years were eligible if they had severe asthma exacerbation defined by the modified pulmonary index score (MPIS). Patients were randomly assigned (1:1) to receive inhalation of l-isoproterenol (10 μg/kg/h) or salbutamol (500 μg/kg/h) for 12 hours via a large-volume nebulizer with oxygen. The primary outcome was the change in MPIS from baseline to 3 hours after starting inhalation. Trial registration number UMIN000001991. ResultsFrom December 2009 to October 2013, 83 patients (42 in the l-isoproterenol group and 41 in the salbutamol group) were enrolled into the study. Of these, one patient in the l-isoproterenol group did not receive the study drug and was excluded from the analysis. Compared with salbutamol, l-isoproterenol reduced MPIS more rapidly. Mean (SD) changes in MPIS at 3 hours were −2.9 (2.5) in the l-isoproterenol group and −0.9 (2.3) in the salbutamol group (difference −2.0, 95% confidence interval −3.1 to −0.9; P < 0.001). Adverse events occurred in 1 (2%) and 11 (27%) patients in the l-isoproterenol and salbutamol groups, respectively (P = 0.003). Hypokalemia and tachycardia occurred only in the salbutamol group. ConclusionsLow-dose l-isoproterenol has a more rapid effect with fewer adverse events than salbutamol.

A Comparative Study of Salbutamol Nebulizer versus Salbutamol plus Budesonide Nebulizer in the Treatment of Children with Acute Asthma Exacerbation

Asthma is a common chronic illness of childhood and represents the leading cause of childhood morbidity as measured by school absence,emergency department visit,and hospitalization. Budesonide is an inhaled corticosteroid used as controller agent and recently introduced as an adjuvant treatment in acute attacks of asthma.To evaluate the effect of combination of budesonide plus salbutamol nebulizer versus salbutamol nebulizer monotherapy in children with acute attack of asthma. A randomized double blind standard control clinical study was done in Karbala teaching hospital for children from1st of November 2015 to the end of November 2016 on patients aged 1-12 years presented to emergency department with mild to moderate acute attack of asthma. The patients randomly divided into salbutamol group (50) patients and salbutamol plus budesonide group (50) patients. For each patient the severity of asthma attack was determined by pulmonary index score (PIS) before initiation of treatment,then assessment done each 30 minutes up to 90 minute to detect the decrement in severity of attack and response to treatment. There was significant reduction in PIS (p&lt;0.05) for both group of patients treated with salbutamol and salbutamol plus Budesonide and after 30, 60 minutes as compare with their baseline score. After 30 minutes from ER admission patients who were treated with combination of salbutamol plus budesonide had significantly lower PISs than those treated with salbutamol alone. At end of 90 minute there were 28 patients from salbutamol group and only 14 patients from combination group with significant difference in number of patient between groups (p&lt;0.05). The mean duration of stay in E.R was significantly shorter (p&lt;0.05) in patients treated with nebulized salbutamol +budesonide. The addition of nebulized budesonide to salbutamol significantly lower the PIS and shorten the duration of stay in emergency department in asthmatic children with acute attack.

B2 agonist (Salbutamol) modulate skin wound healing processes

Wound healing is a complex physiological and dynamic process required the coordination of numerous cell types and biological processes to regenerate damaged tissue and initiate repair which is dependent on a number of inter-related factors. This study was aimed to demonstrate whether the ?2 receptor has role in wound healing and angiogenesis. A murine wild-type (in vivo), excisional skin wound model was done to demonstrate that activation of ?2AR delay wound repair, twenty-four male albino mice were used to investigate the effect of the drug on experimental wound healing grossly, histo-pathologically and immune-histochemically compared with vehicle-only controls. The results showed that the rate of wound healing was significantly slower in salbutamol group than in control group (P

The Effect of Inhaled Salbutamol in Transient of Tachypnea of the Newborn: A Randomized Clinical Trial

Background: Transient tachypnea of the newborn (TTN) is a common cause of respiratory distress in the neonatal period. There are few data regarding the pharmacotherapy for the management of TTN. Previous studies documented the therapeutic role for the beta2 agonists in TTN by accelerating the clearance of excessive fluid from the alveolar space. The aim of present study was to assess the effect of salbutamol on major clinical outcomes including duration of oxygen therapy and improvement of respiratory symptoms. Methods: This double blinded randomized clinical trial was conducted in 2014 in three urban tertiary care centers of Babol, North of Iran. Patients were assigned to receive either inhalational salbutamol (35 patients) or placebo (35 patients), and clinical outcomes were compared Before and after treatment in interval of 30 minutes, one, four and six hours from the beginning of the study. Results: There was no significant difference between the clinical findings of salbutamol and placebo group before and 24 hours after the initiation of the study. After the exclusion of the neonates with retraction silverman anderson scor < 2, in salbutamol group the mean values of primary outcomes including; duration of oxygen therapy (P = 0.04) and hospitalization (P = 0.006) as well as initiation of enteral feeding (P = 0.013) were significantly lower than in placebo group. Conclusions: Inhaled salbutamol resulted in shorter duration of respiratory support and hospitalization and earlier initiation of enteral feeding in TTN patients with moderate to severe respiratory symptoms. Further RCT studies with a larger study population and higher retraction score are suggested to achieve valid data in the management of TTN.

Effectiveness and safety of the oxytocin antagonist( atosiban) versus beta-adrenergic agonists (salbutamol) in the treatment of preterm labor

Background and Objectives: preterm labor complicates 5-10% of pregnancies and is a leading cause of neonatal morbidity and mortality worldwide and 70-80% of perinatal deaths occur in preterm infants. The aim of this study is to compare the effectiveness, safety and adverse effects of the oxytocin antagonist medication(atosiban) with those of beta-adrenergic agonist (salbutamol) in the treatment of patients with preterm labor.Patients and Methods: one hundred pregnant women with preterm labor were enrolled in this study from the period of( January 2014 – January 2015) at Al-Diwaniya Maternity and Pediatrics Teaching Hospital-Iraq with a gestational age of 24-34 weeks, they were randomly assigned to receive tocolytics either salbutamol (n=50) or atosiban (n=50).Salbutamol was given by(intravenous infusion 10-50 microgram)for up to 48 hour. Atosiban was given by (intravenous bolus dose of 6.75 mg then 300microgram/minute for 3 hour and 100microgram/minute for up to 48hour). Retreatment with the study drugs or alternative tocolytic agents was allowed. Main outcome measures included were tocolytic effectiveness, which was assessed in terms of number of women undelivered after 48hour and 7 days. Tocolytic safety was assessed in terms of maternal and fetal side effects and neonatal morbidity.Results: there were no significant differences between the salbutamol and the atosiban group in prolongation of pregnancy for 48 hour (44% versus 46%;p=0841)and 7 days(20% versus 32%;p=0.171) ,respectively. Maternal adverse events , including tachycardia occurred more frequently in the salbutamol group(22% versus 8%;p=0.050).Neonatal outcomes and complications were comparable between the two study groups(42% versus 32%;p=0.30).Conclusions: the oxytocin antagonist (atosiban) was as effective as beta-agonist(salbutamol) in delaying threatened preterm birth , and found to be better tolerated by both the mother and fetus than salbutamol , with a comparable neonatal safety profil.This study supports the clinical use of atosiban as a first line tocolytic in the treatment of preterm labor.

Premedication with salbutamol prior to surgery does not decrease the risk of perioperative respiratory adverse events in school-aged children

BackgroundPerioperative respiratory adverse events (PRAE) remain the leading cause of morbidity and mortality in the paediatric population. This double-blinded randomized control trial investigated whether inhaled salbutamol premedication decreased the occurrence of PRAE in children identified as being at high risk of PRAE. MethodsChildren with at least two parentally reported risk factors for PRAE undergoing elective surgery were eligible for recruitment. They were randomized to receive either salbutamol (200 µg) or placebo prior to their surgery and PRAE (bronchospasm, laryngospasm, airway obstruction, desaturation, coughing and stridor) were recorded. ResultsOut of 470 children (6–16 yr, 277 males, 59%) recruited, 462 were available for an intention-to-treat analysis. Thirty-two (14%) and 27 (12%) children from the placebo and salbutamol groups experienced PRAE. This difference was not significant [odds ratio (OR): 0.83, 95% confidence interval (CI): 0.48–1.44, P: 0.51]. Oxygen desaturation [14/232 (6%) vs 14/230 (6%), OR: 1.01, 95% CI: 0.47–2.17, P: 0.98] and severe coughing [12/232 (5%) vs 10/230 (4%), OR: 0.83, 95% CI: 0.35–1.97, P: 0.68] were the most common PRAE, but did not significantly differ between the groups. The occurrence of PRAE was slightly lower in children with respiratory symptoms who received salbutamol compared with placebo [16/134 (12%) vs 21/142 (15%), OR: 0.93, 95% CI: 0.38–2.26, P: 0.87], but was not significantly different. ConclusionsPremedication with salbutamol to children aged between 6 and 16 years and at high risk of PRAE prior to their surgery did not reduce their risk of PRAE. Trial registration numberACTRN12612000626864 (www.anzctr.org.au).

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Comparison of clinical efficacy and safety between salbutamol-ipratropium bromide nebulization and salbutamol alone in children with asthmatic attack

Background Indonesian guidelines for childhood asthma recom-mend giving ipratropium bromide when there are no improvementafter 2 times salbutamol nebulization. The efficacy and safety ofearly nebulization of ipratropium bromide combined with salbutamolas first line in moderate asthma exacerbation in children are stillunknown.Objective To compare efficacy and safety between nebulizedsalbutamol-ipratropium bromide and salbutamol alone in childrenwith moderate asthma exacerbation.Methods Fifty-two children (2-6 years) with acute asthma (clinicalscore 5-10) were enrolled into a randomized single blind controlledtrial comparing 2 groups of 2.5 mg nebulized salbutamol (group 1)and 2.5 mg salbutamol combined with 0.5 mg ipratropium bromide(group 2). Nebulization was given until clinical score decreased&lt;5, maximum of 3 doses during 2 hours. Clinical measurementsincluded clinical score, oxygen saturation and side effects whichwere assessed every 20 minutes up to 120 minutes. Statisticaltest for homogeneity and comparison of clinical outcomes and sideeffects used independent t-test, Fisher’s exact test, and Mann-Whitney U test (P&lt;0.05).Results The groups were similar in all baseline measures. Therewere significantly decreasing clinical score in groups 2 at 20, 40,60, 80, 100, and 120 minutes (P&lt;0.05), and the means of oxygensaturation were significantly higher in group 2 at 20, 40, 60, 80,100, and 120 minutes (P&lt;0.05). In group 1, 11.5% of patients werehospitalized after the study and none in groups 2 (P&gt; 0.05). Therewere no toxic effects attributable to ipratropium bromide, and theside effects were not different between these two groups.Conclusion The combination of nebulized ipratropium bromideand salbutamol in a child with acute moderate asthma exacerba-tion was associated with higher reduction of clinical score and higheroxygen saturation, and may reduce hospitalization

Effectiveness of intratracheal salbutamol in addition to surfactant on the clinical course of newborns with respiratory distress syndrome: a clinical trial.

BackgroundIn addition to surfactant deficiency, increase of lung fluid content and secretion of fluid derived from the blood participate in the pathogenesis of RDS in newborns.We hypothesized that the administration of salbutamol (β-agonist) to increase lung fluid absorption would decrease the INSURE failure rate in newborns with respiratory distress syndrome (RDS) treated with intratracheal surfactant.MethodsDesignBlinded, randomized clinical trial study.Setting/populationLevel III NICU, premature infants with RDS requiring intratracheal Surfactant.Forty Eight newborns with RDS treated with intratracheal Surfactant were randomized into two groups as Group A, Normal saline (as control group) and Group B (intervention group), Salbutamol were administered intratracheally in addition to Surfactant. Intubation-Surfactant administration- Rapid Extubation (INSURE) failure rate as primary outcome and secondary outcome as follow: duration of the need to NCPAP, mechanical ventilation and oxygen therapy; complications (patent ductus arteriosus, pneumothorax); mortality (respiratory or prematurity related complication) and the duration of hospitalization were assessed.ResultsTwenty Four patients in each group were studied. INSURE failure was seen in16 (66.7 %) and 10 (41.7 %) of normal saline and salbutamol groups respectively (p = 0.082). The duration of NCPAP in control group was 69.5 ± 54.9 h while in Salbutamol group was 51.6 ± 48.7 h (p = 0.316). All of deaths were related to respiratory failure. No differences in mortality or complications of RDS were observed. The duration of hospitalization was longer in control group than interventional group, 28.3 ± 18.1 and 18.6 ± 8.6 days, respectively. (p = 0.047).ConclusionSalbutamol may improve the clinical course of newborns with RDS requiring Surfactant.Trial registration numberIRCT2014072714215N1

Formoterol as reliever medication in asthma: a post-hoc analysis of the subgroup of the RELIEF study in East Asia.

BackgroundAs-needed formoterol can effectively relieve asthma symptoms. Since budesonide/formoterol is available as maintenance and reliever therapy in Asia, formoterol is now being used as-needed, but always with concomitant inhaled corticosteroids. The objective of this analysis was to assess the safety and efficacy of formoterol therapy in patients in East Asia (China, Indonesia, Korea, the Philippines and Singapore) with asthma.MethodsPost-hoc analyses of data from the East Asian population of the RELIEF (REal LIfe EFfectiveness of Oxis® Turbuhaler® as-needed in asthmatic patients; study identification code: SD-037-0699) study were performed.ResultsThis sub-group comprised 2834 randomised patients (formoterol n = 1418; salbutamol n = 1416) with mean age 35 years; 50.7 % were male. 2678 patients completed the study. There was no significant difference in the total number of adverse events (AEs) reported in the formoterol and salbutamol groups (21.3 % vs 20.9 % of patients; p = 0.813), nor in the total number of serious AEs and/or discontinuations due to AEs (4.6 % vs 5.5 %, respectively; p = 0.323). Compared with salbutamol, formoterol was associated with a significantly longer time to first exacerbation (hazard ratio 0.86; p = 0.023) and a 14 % reduction in the risk of any exacerbation (p < 0.05). Relative to salbutamol, mean adjusted reliever medication use throughout the study was significantly lower in the formoterol group (p = 0.017) and the risk of increased asthma medication use was 20 % lower with formoterol (p = 0.005).ConclusionsAmong patients with asthma in East Asia, as-needed formoterol and salbutamol had similar safety profiles but, compared with salbutamol, formoterol reduced the risk of exacerbations, increased the time to first exacerbation and reduced the need for reliever medication.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0166-0) contains supplementary material, which is available to authorized users.

Is Salbutamol and Adrenalin Inhalation Effective in Management of Transient Tachypnia of Newborn?

Background: In the neonatal period, transient tachypnea of the newborn (TTN) is the most frequent cause of early respiratory distress because of delayed resorption of lung fluid, which fills the fetal airways. The inability of the lung to switch from fluid secretion to fluid absorption and immaturity in the expression of epithelial Nachannels (ENaC) may play an important role in the development of transient tachypnea of the newborn. Aims: Evaluation of inhalation therapy by BETA-2 agonist salbutamol and epinephrine for the management of transient tachypnea of newborn. Methods: The study was a prospective randomized control study. It included 60 neonates diagnosed clinically and radiologicaly as TTN. Inhaled salbutamol, epinephrine or saline 0.45% solution was administered. Results: Comparing studied groups after intervention, highly significant lower respiratory rate, TTN scores, respiratory support and duration of hospital stay was detected in group II (salbutamol group) while no significant difference between groups regarding heart rate after 4 hours from intervention. Original Research Article Nawar et al.; BJMMR, 14(3): 1-8, 2016; Article no.BJMMR.23922 2 Conclusion: Inhaled Salbutamol resulted in better outcome in decreasing the respiratory rate, TTN clinical score, lower FIO2, higher O2 saturation, decreasing the duration of respiratory support along with the total duration of hospitalization.

Effectiveness of 3% hypertonic saline nebulization in acute bronchiolitis among Indian children: A quasi-experimental study.

Objective:To compare the effects of 3% hypertonic saline (HS) and 0.9% normal saline with nebulized 0.9% normal saline with salbutamol in patients of acute viral bronchiolitis.Materials and Methods:Participants were divided into three groups, that is, 3% HS group, 0.9% normal saline group and 0.9% saline with salbutamol group. Four doses at interval of 6 h were given daily until discharge. Average CS score and length of hospital stay were compared. One-way analysis of variance paired t-test and Chi-square test were utilized for statistical analysis.Results:The mean ages of the patients in three groups were 6.03 ± 3.71, 5.69 ± 3.34 and 5.48 ± 3.35 respectively. The 3rd day CS scores for all the groups were 1.0 ± 1.1, 1.9 ± 1.1 and 3.3 ± 0.5 respectively (P = 0.000). The average length of hospital stay was 3.4 ± 1.7, 3.7 ± 1.9 and 4.9 ± 1.4 days respectively (P = 0.001).Conclusion:The present study concludes that 3% HS nebulization (without additional bronchodilators) is an effective and safe treatment for nonasthmatic, moderately ill patients of acute bronchiolitis. The economic benefit of this comparably priced modality of treatment can be enormous in terms of hospital costs with parents returning to work sooner.

Effect of Traditional Chinese Medicine on Inflammatory Mediators in Pediatric Asthma

Objective. To observe the effects of empirical prescriptions of traditional Chinese medicine (TCM) on inflammatory mediators in pediatric asthma and to explore the underlying molecular mechanism in the treatment of asthma. Methods. A total of 182 children with asthma were randomly placed into either the TCM group (n = 97) or the salbutamol and montelukast (SM) group (n = 85). Patients in the TCM group were treated with a series of empirical prescriptions of TCM, while those in the SM group received salbutamol and montelukast. Both groups received their respective treatment for 12 weeks. There were 35 patients in TCM group and 34 patients in SM group providing venous blood. Real-time PCR was used to determine the mRNA expression levels of interleukin- (IL-) 10, IL-17, matrix metalloproteinase-9 (MMP-9), and transforming growth factor β1 (TGF-β1) in peripheral blood mononuclear cells before and after treatment. Enzyme-linked immunosorbent assay was used to measure the levels of IL-10, IL-17, MMP-9, and TGF-β1 in peripheral blood before and after treatment. Results. The mRNA expression of TGF-β1 in the SM group was downregulated (P = 0.00) after treatment. No significant differences were found between the TCM group and the SM group after treatment (P > 0.05). In the TCM group, the levels of IL-10, IL-17, and MMP-9 significantly decreased after treatment (P = 0.01, 0.04, and 0.03, resp.). In the SM group, IL-17, MMP-9, and TGF-β1 levels significantly decreased after treatment (P = 0.00, 0.03, and 0.00, resp.). There was no significant difference between the two groups regarding the levels of IL-10, IL-17, TGF-β1, and MMP-9 (P > 0.05). The difference of the level of IL-17 was negatively correlated with the change of C-ACT score in TCM group and SM group. Conclusion. TCM has a regulatory effect on the balance of some inflammatory mediators in pediatric asthma.