Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial
Background: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on inf...
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doaj-2798b9db232d4c778ff4f161173462932021-08-09T23:31:14ZengWolters Kluwer Medknow PublicationsAvicenna Journal of Medicine2231-07702249-44642014-07-010403586510.4103/2231-0770.133333Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trialManal Bawazeer0Majed Aljeraisy1Esam Albanyan2Alanazi Abdullah3Wesam Al Thaqafi4Jaber Alenazi5Zaam Al otaibi6Mohammed Al Ghaihab7Department of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Emergency, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Respiratory Services, King Abdulaziz Medical City, Riyadh, Saudi ArabiaDepartment of Pediatric, King Abdulaziz Medical City, Riyadh, Saudi ArabiaBackground: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on infants (1 to 12 months) who were diagnosed in the emergency department with moderate-to-severe bronchiolitis. The primary outcome was the rate of hospital admission within 7 days of the first dose of treatment, and the secondary outcomes were changes in respiratory distress assessment instrument score, heart rate, respiratory rate, and oxygen saturation (O 2 Sat) over a 4-hour observation period. Infants (n = 162) were randomly assigned to four groups: A (dexamethasone + racemic epinephrine) = 45, B (placebo and racemic epinephrine) =39, C (dexamethasone and salbutamol) = 40, or D (placebo and salbutamol) = 38. Results: Patients who had received dexamethasone + epinephrine exhibited similar admission rates compared to placebo + epinephrine or salbutamol (P = 0.64). Similarly, no statistically significant difference was observed in the rate of hospitalization for patients who received dexamethasone + salbutamol compared to those who received placebo + epinephrine or salbutamol (P = 0.51). Clinical parameters were improved at the end of the 4-hour observation period for all treatment groups. Treatment with dexamethasone + epinephrine resulted in a statistically significant change in HR over time (P < 0.005) compared to the other groups. Conclusions: This study adds to a body of evidence suggesting that corticosteroids have no role in the management of bronchiolitis for young infants who are first time wheezers with no risk of atopy.http://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.133333bronchiolitisdexamethasonesalbutamolalbuterolbeta2 agonistracemicepinephrineefficacyrandomized trial |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Manal Bawazeer Majed Aljeraisy Esam Albanyan Alanazi Abdullah Wesam Al Thaqafi Jaber Alenazi Zaam Al otaibi Mohammed Al Ghaihab |
spellingShingle |
Manal Bawazeer Majed Aljeraisy Esam Albanyan Alanazi Abdullah Wesam Al Thaqafi Jaber Alenazi Zaam Al otaibi Mohammed Al Ghaihab Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial Avicenna Journal of Medicine bronchiolitis dexamethasone salbutamol albuterol beta2 agonist racemic epinephrine efficacy randomized trial |
author_facet |
Manal Bawazeer Majed Aljeraisy Esam Albanyan Alanazi Abdullah Wesam Al Thaqafi Jaber Alenazi Zaam Al otaibi Mohammed Al Ghaihab |
author_sort |
Manal Bawazeer |
title |
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial |
title_short |
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial |
title_full |
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial |
title_fullStr |
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial |
title_full_unstemmed |
Effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial |
title_sort |
effect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: a randomized, double-blind, controlled trial |
publisher |
Wolters Kluwer Medknow Publications |
series |
Avicenna Journal of Medicine |
issn |
2231-0770 2249-4464 |
publishDate |
2014-07-01 |
description |
Background: This study investigated the effect of combining oral dexamethasone with either nebulized racemic epinephrine or salbutamol compared to bronchodilators alone for the treatment of infants with bronchiolitis. Materials and Methods: This was a double-blind, randomized controlled trial on infants (1 to 12 months) who were diagnosed in the emergency department with moderate-to-severe bronchiolitis. The primary outcome was the rate of hospital admission within 7 days of the first dose of treatment, and the secondary outcomes were changes in respiratory distress assessment instrument score, heart rate, respiratory rate, and oxygen saturation (O 2 Sat) over a 4-hour observation period. Infants (n = 162) were randomly assigned to four groups: A (dexamethasone + racemic epinephrine) = 45, B (placebo and racemic epinephrine) =39, C (dexamethasone and salbutamol) = 40, or D (placebo and salbutamol) = 38. Results: Patients who had received dexamethasone + epinephrine exhibited similar admission rates compared to placebo + epinephrine or salbutamol (P = 0.64). Similarly, no statistically significant difference was observed in the rate of hospitalization for patients who received dexamethasone + salbutamol compared to those who received placebo + epinephrine or salbutamol (P = 0.51). Clinical parameters were improved at the end of the 4-hour observation period for all treatment groups. Treatment with dexamethasone + epinephrine resulted in a statistically significant change in HR over time (P < 0.005) compared to the other groups. Conclusions: This study adds to a body of evidence suggesting that corticosteroids have no role in the management of bronchiolitis for young infants who are first time wheezers with no risk of atopy. |
topic |
bronchiolitis dexamethasone salbutamol albuterol beta2 agonist racemic epinephrine efficacy randomized trial |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.133333 |
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