مقايسه ي اثر اپي نفرين استنشاقي با سالبوتامول در درمان شيرخواران مبتلا به برونشيوليت حاد

Comparison of nebulized epinephrine versus salbutamol in the treatment of infants with acute bronchiolitis

Objective: Acute bronchiolitis is a common disease of the lower respiratory tract in infants, resulting from inflammatory obstruction of small airways. The treatment of infants with bronchiolitis is largely supportive. The role of bronchodilators is controversial. The aim of this study was to compare the efficacy of nebulized epinephrine and salbutamol in the treatment of patients admitted in emergency department with the diagnosis of bronchiolitis. Subjects and Methods: Fifty-two infants between 2 and 12 months with clinical diagnosis of bronchiolitis were randomized in to receive either 0.5mg/kg, maximum 2.5mg, of nebulized 1 in 1000 epinephrine, (n=25) or 0.15mg/kg of nebulized salbutamol (n=25). Pulse rate, respiratory rate and O2 saturation with pulse oximetry were recorded before, 30, 60, 90 and 120 minutes after treatment. Results: Both nebulized epinephrine and salbutamol caused a significant improvement in the mean clinical score and oxygenation. Tachycardia was found to occur more significantly in the epinephrine group and relapse was found more frequent in the salbutamol group. Infants aged less than 6 months showed a better response to nebulized epinephrine. While infants aged more than 6 months responded to salbutamol better than to epinephrine. Conclusion: Result of this study showed that both nebulized epinephrine and salbutamol are effective in the treatment of patients with acute bronchiolitis. But among infants under 6 months age, epinephrine is more effective than salbutamol