Ralston Shawn, Hartenberger Carol, Anaya Theresa, Qualls Clifford, Kelly H William
Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Pediatr Pulmonol. 2005 Oct;40(4):292-9. doi: 10.1002/ppul.20260.
Our objective was to determine if nebulized racemic epinephrine is more efficacious than nebulized albuterol or saline placebo in the treatment of bronchiolitis in the outpatient setting when dosing is equivalent in terms of beta-2 agonist potency. Sixty-five patients between ages 6 weeks and 24 months with a diagnosis of bronchiolitis, defined as first-time wheezing, upper respiratory symptoms and/or fever, and a Respiratory Distress Assessment Instrument score of at least 4, were randomized to receive 5 mg nebulized albuterol, 5 mg nebulized racemic epinephrine, or an equivalent volume of placebo at 0, 30, and 60 min. The primary outcome measure was need for hospital admission or home oxygen. Secondary outcome measures were changes in clinical scores and oxygen saturations. There were no significant statistical differences between groups in terms of need for hospital admission or outpatient management with home oxygen therapy. There were no differences between groups in terms of changes in clinical scores or oxygen saturations. Racemic epinephrine and albuterol at equivalent doses had no effect on the need for hospitalization or supplemental oxygen in bronchiolitis in the outpatient setting compared to nebulized saline placebo, though this study may have missed less dramatic clinical effects due to small sample size.
我们的目的是确定在门诊环境中，当剂量在β-2激动剂效力方面相等时，雾化消旋肾上腺素在治疗细支气管炎方面是否比雾化沙丁胺醇或生理盐水安慰剂更有效。65名年龄在6周至24个月之间、诊断为细支气管炎（定义为首次喘息、上呼吸道症状和/或发热，且呼吸窘迫评估仪器评分至少为4分）的患者，被随机分为在0、30和60分钟时接受5毫克雾化沙丁胺醇、5毫克雾化消旋肾上腺素或等量安慰剂治疗。主要结局指标是住院需求或家庭吸氧需求。次要结局指标是临床评分和血氧饱和度的变化。在住院需求或家庭吸氧门诊管理方面，各组之间没有显著的统计学差异。在临床评分或血氧饱和度变化方面，各组之间也没有差异。与雾化生理盐水安慰剂相比，等量剂量的消旋肾上腺素和沙丁胺醇对门诊细支气管炎患者的住院需求或补充氧气需求没有影响，不过由于样本量小，本研究可能遗漏了不太明显的临床效果。
