The study took place at a tertiary care center. 42 children (age
6 weeks to 1 year) were randomized to receive either inhaled Epinephrine
or Salbutamol. Patients were excluded for the following: chronic
lung or heart disease, previous diagnosis of asthma, previous
bronchodilator use, severe disease, or use of steroids within
the past 24 hours.1
Patients were given with Salbutamol (.3cc + 2.7cc of normal saline)
or 3cc of 1:1000 epinephrine. RDAI, respiratory rate, heart rate,
and oxygen saturation were measured at baseline, 30 minutes, 60
minutes, and 90 minutes. Adverse effects (tremors, pallor, and
emesis) were noted by the participating physicians. Secondary
outcomes were admission and length of stay.
Patients in the Epinephrine group were found to have a higher
oxygen saturation at 60 minutes as compared to the Salbutamol
group. This difference disappeared by 90 minutes. In addition
the epinephrine-treated group had a lower heart rate at 90 minutes.
81% of the patients in the Salbutamol group were admitted vs.
33% in the Epinephrine group (p=0.033). The ARR is 49% and the
NNT is 2.
Adverse effects were similar for both groups.