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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Thieme Medical and Scientific Publishers Pvt. Ltd.
2014
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oai:doaj.org-article:2798b9db232d4c778ff4f161173462932021-12-02T17:05:52ZEffect of combined dexamethasone therapy with nebulized r-epinephrine or salbutamol in infants with bronchiolitis: A randomized, double-blind, controlled trial2231-07702249-446410.4103/2231-0770.133333https://doaj.org/article/2798b9db232d4c778ff4f161173462932014-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.4103/2231-0770.133333https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Background: 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.Manal BawazeerMajed AljeraisyEsam AlbanyanAlanazi AbdullahWesam Al ThaqafiJaber AlenaziZaam Al otaibiMohammed Al GhaihabThieme Medical and Scientific Publishers Pvt. Ltd.articlebronchiolitisdexamethasonesalbutamolalbuterolbeta2 agonistracemicepinephrineefficacyrandomized trialMedicineRENAvicenna Journal of Medicine, Vol 04, Iss 03, Pp 58-65 (2014) |
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bronchiolitis dexamethasone salbutamol albuterol beta2 agonist racemic epinephrine efficacy randomized trial Medicine R |
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bronchiolitis dexamethasone salbutamol albuterol beta2 agonist racemic epinephrine efficacy randomized trial Medicine R 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 |
| 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. |
| format |
article |
| author |
Manal Bawazeer Majed Aljeraisy Esam Albanyan Alanazi Abdullah Wesam Al Thaqafi Jaber Alenazi Zaam Al otaibi Mohammed Al Ghaihab |
| 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 |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
| publishDate |
2014 |
| url |
https://doaj.org/article/2798b9db232d4c778ff4f16117346293 |
| work_keys_str_mv |
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