Albuterol over Epinephrine in Infants with Bronchiolitis

Filed in archive Cases , Treatment on May 17, 2007

The most common cause of hospital admissions in infants is the condition called bronchiolitis - a wheezing very similar to asthma in adults.

Generally used to treat this condition are two drugs: epinephrine (a sympathomimetic agent) and albuterol (a bronchodilator).

However, there is some controversy in choosing one over the other.

Like in the treatment of most allergic reaction, epinephrine works by relaxing the muscles in the airways and tightening the blood vessels, thereby bringing relief to a bronchiolitic infant.

Epinephrine is usually delivered by injection while albuterol is by inhalation. Albuterol also works by relaxing and opening air passages to the lungs to make breathing easier.

Now, a double-blind randomized clinical trial that involved over 700 infants over a three year period demonstrated a clear advantage for albuterol in successful discharges of bronchiolitic infants from the Emergency Department.

Findings will be presented in a paper at the 2007 Society for Academic Emergency Medicine (SAEM) Annual Meeting (May 16-19, 2007, Chicago, IL.).

This surprising result may force physicians to reassess their treatment choices and prefer albuterol.

[Paper title: "A Double Blind Randomized Controlled Trial Comparing Nebulized Epinephrine And Albuterol In The Emergency Department Treatment Of Bronchiolitis" by Paul Walsh MD, of the Kern Medical Center, Bakersfield & David Geffen School of Medicine at the UCLA, Los Angeles, CA.]

Source: Science Daily