PEDIATRICS Vol. 101 No. 3 March 1998, pp. 361-368
The Use of Albuterol in Hospitalized Infants With Bronchiolitis
Received Dec 10, 1996; accepted Aug 12, 1997.
From the * Department of Pediatrics and the Office of Medical
Research, Department of Academic Affairs, Maricopa Medical Center,
Phoenix, Arizona.
Objectives. To determine whether the use of albuterol by nebulization enhances physiologic or clinical recovery in hospitalized infants with moderate bronchiolitis.
Methods. This prospective, double-blind, placebo-controlled, randomized clinical trial was performed from December 1995 to March 1996. A total of 52 patients <24 months of age with a diagnosis of moderately severe, acute viral bronchiolitis were enrolled and assigned to receive nebulized albuterol or normal saline placebo for 72 hours under a standardized protocol. Primary outcome measures included improvement in oxygen saturation (SaO2) during hospitalization and survival analysis to assess the time required to reach preestablished discharge criteria on three measures: SaO2, accessory muscle use, and wheezing. An additional secondary outcome measure was actual length of hospital stay. Adverse outcomes also were compared between treatment groups.
Results. There was no significant difference in mean SaO2 between albuterol and placebo at baseline, 24 hours, or maximum SaO2 achieved during hospitalization. Both groups showed significant improvement in oxygen saturation over time, but there was no significant difference in improvement between the two groups. The study had a power of 90% to detect a difference in mean percentage point improvement of 2% SaO2. There was no difference in time to reach discharge criteria as defined by SaO2, accessory muscle use, or wheezing. There was no difference in length of hospital stay or in the frequency of adverse outcomes.
Conclusions. Nebulized albuterol therapy does not appear to enhance recovery or attenuate severity of illness in infants hospitalized with acute, moderate bronchiolitis, as evidenced by improvement in oxygen saturation, time to meet standardized discharge criteria, or length of hospital stay.
Key words: bronchiolitis, respiratory syncytial virus infections, infant, wheezing, hospitalization, albuterol, adrenergic
-agonists,
bronchodilator
agents.
This article has been cited by other articles:
 |
|
 |
|
  Subcommittee on Diagnosis and Management of Bronch Diagnosis and Management of Bronchiolitis Pediatrics, October 1, 2006; 118(4): 1774 - 1793. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. K. Rubin What Does It Mean When a Patient Says, "My Asthma Medication Is Not Working?" Chest, September 1, 2004; 126(3): 972 - 981. [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. Schroeder, A. K. Marmor, R. H. Pantell, and T. B. Newman Impact of Pulse Oximetry and Oxygen Therapy on Length of Stay in Bronchiolitis Hospitalizations Arch Pediatr Adolesc Med, June 1, 2004; 158(6): 527 - 530. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. C. Mull, R. J. Scarfone, L. R. Ferri, T. Carlin, C. Salvaggio, K. A. Bechtel, M. A. H. Trephan, R. L. Rissman, and E. J. Gracely A Randomized Trial of Nebulized Epinephrine vs Albuterol in the Emergency Department Treatment of Bronchiolitis Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 113 - 118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. C. Bordley, M. Viswanathan, V. J. King, S. F. Sutton, A. M. Jackman, L. Sterling, and K. N. Lohr Diagnosis and Testing in Bronchiolitis: A Systematic Review Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 119 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. J. King, M. Viswanathan, W. C. Bordley, A. M. Jackman, S. F. Sutton, K. N. Lohr, and T. S. Carey Pharmacologic Treatment of Bronchiolitis in Infants and Children: A Systematic Review Arch Pediatr Adolesc Med, February 1, 2004; 158(2): 127 - 137. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. I. Paul Oral Albuterol Is of No Benefit for Infants with Bronchiolitis AAP Grand Rounds, August 1, 2003; 10(2): 15 - 15. [Full Text] [PDF]
|
|
|
|
|
|
A. Mandelberg, G. Tal, M. Witzling, E. Someck, S. Houri, A. Balin, and I. E. Priel Nebulized 3% Hypertonic Saline Solution Treatment in Hospitalized Infants With Viral Bronchiolitis Chest, February 1, 2003; 123(2): 481 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. D. Mallory, D. K. Shay, J. Garrett, and W. C. Bordley Bronchiolitis Management Preferences and the Influence of Pulse Oximetry and Respiratory Rate on the Decision to Admit Pediatrics, January 1, 2003; 111(1): e45 - 51. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Sarrell, G. Tal, M. Witzling, E. Someck, S. Houri, H. A. Cohen, and A. Mandelberg Nebulized 3% Hypertonic Saline Solution Treatment in Ambulatory Children With Viral Bronchiolitis Decreases Symptoms Chest, December 1, 2002; 122(6): 2015 - 2020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Todd, D. Bertoch, and S. Dolan Use of a Large National Database for Comparative Evaluation of the Effect of a Bronchiolitis/Viral Pneumonia Clinical Care Guideline on Patient Outcome and Resource Utilization Arch Pediatr Adolesc Med, November 1, 2002; 156(11): 1086 - 1090. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. R. Kotagal, J. M. Robbins, N. M. Kini, P. J. Schoettker, H. D. Atherton, and M. S. Kirschbaum Impact of a Bronchiolitis Guideline* : A Multisite Demonstration Project Chest, June 1, 2002; 121(6): 1789 - 1797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M. Kini, J. M. Robbins, M. S. Kirschbaum, S. J. Frisbee, U. R. Kotagal, and for the Child Health Accountability Initiative Inpatient Care for Uncomplicated Bronchiolitis: Comparison With Milliman and Robertson Guidelines Arch Pediatr Adolesc Med, December 1, 2001; 155(12): 1323 - 1327. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Willson, S. D. Horn, J. O. Hendley, R. Smout, and J. Gassaway Effect of Practice Variation on Resource Utilization in Infants Hospitalized for Viral Lower Respiratory Illness Pediatrics, October 1, 2001; 108(4): 851 - 855. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. C. Meissner Uncertainty in the Management of Viral Lower Respiratory Tract Disease Pediatrics, October 1, 2001; 108(4): 1000 - 1003. [Full Text] [PDF]
|
|
|
|
|
|
P. H. Perlstein, U. R. Kotagal, C. Bolling, R. Steele, P. J. Schoettker, H. D. Atherton, and M. K. Farrell Evaluation of an Evidence-based Guideline for Bronchiolitis Pediatrics, December 1, 1999; 104(6): 1334 - 1341. [Abstract] [Full Text]
|
|
|
|
|
|
P. M. Adcock, C. L. Sanders, and G. S. Marshall Standardizing the Care of Bronchiolitis Arch Pediatr Adolesc Med, August 1, 1998; 152(8): 739 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Albuterol Does Not Benefit Hospitalized Children with Bronchiolitis Journal Watch (General), March 10, 1998; 1998(310): 3 - 3. [Full Text]
|
|
