Gadomski A M, Aref G H, el Din O B, el Sawy I H, Khallaf N, Black R E
Department of Pediatrics, University of Maryland, Baltimore.
J Pediatr. 1994 Jan;124(1):131-8. doi: 10.1016/s0022-3476(94)70269-1.
The efficacy of albuterol in the management of infants with first-time wheezing is controversial. This double-blind, placebo-controlled trial involved 128 Egyptian infants with first-time wheezing (mean age 5.9 months) who were randomly separated into four equivalent therapy groups: nebulized albuterol, nebulized saline solution, orally administered albuterol, and orally administered placebo. The nebulized therapy groups received two treatments 30 minutes apart; the oral therapy groups received one treatment. In addition, 41 infants with recurrent wheezing comprised an open-label control group who received two albuterol nebulizations. Chest radiographs, leukocyte counts, blood culture specimens, and nasal aspirate for viral antigen detection were obtained to confirm the clinical diagnosis of viral bronchiolitis. Respiratory and heart rates, clinical score, and oxygen saturation were recorded at baseline and 30 and 60 minutes after treatment. There was no difference among the four randomized groups in any of the outcomes except for an increase in heart rate of 10 beats/min in the nebulized albuterol group compared with a decrease in heart rate of 8 beats/min in the oral placebo group. No differences in the need for additional treatment were observed. Nebulized albuterol significantly improved the clinical score and reduced the respiratory rate of those with recurrent wheezing relative to those in the randomized groups. We conclude that nebulized albuterol is effective in the treatment of infants with recurrent wheezing, but there was no demonstrable efficacy of orally administered or nebulized albuterol in relieving the respiratory distress of infants with bronchiolitis in Egypt.
沙丁胺醇在初次喘息婴儿治疗中的疗效存在争议。这项双盲、安慰剂对照试验纳入了128名埃及初次喘息婴儿（平均年龄5.9个月），他们被随机分为四个等效治疗组：雾化沙丁胺醇组、雾化生理盐水组、口服沙丁胺醇组和口服安慰剂组。雾化治疗组间隔30分钟接受两次治疗；口服治疗组接受一次治疗。此外，41名反复喘息婴儿组成开放标签对照组，接受两次沙丁胺醇雾化治疗。获取胸部X光片、白细胞计数、血培养标本以及用于病毒抗原检测的鼻腔吸出物，以确诊病毒性细支气管炎的临床诊断。在基线、治疗后30分钟和60分钟记录呼吸和心率、临床评分以及血氧饱和度。除雾化沙丁胺醇组心率增加10次/分钟，而口服安慰剂组心率下降8次/分钟外，四个随机分组在任何结局方面均无差异。未观察到额外治疗需求的差异。相对于随机分组的婴儿，雾化沙丁胺醇显著改善了反复喘息婴儿的临床评分并降低了呼吸频率。我们得出结论，雾化沙丁胺醇对反复喘息婴儿有效，但在埃及，口服或雾化沙丁胺醇在缓解细支气管炎婴儿的呼吸窘迫方面并无明显疗效。
