Comparison of Adrenaline and Salbutamol nebulization in treatment of Children with Bronchiolitis.

Abstract

Background: Bronchiolitis is an acute inflammation of bronchioles that can be severe enough to require admission in intensive care unit. There are multiple modalities used for treatment of bronchiolitis. The objective of this study was to compare the response of adrenaline and salbutamol nebulization in terms of clinical improvement and duration of hospital stay. Study Design: Randomized controlled trial. Setting: Pediatrics Department of Avicenna Medical College and Hospital, Lahore. Period: March 2018 to October 2018. Methods: Total 66 patients with 33 in each group between ages of 2-months to 3-years admitted with the diagnosis of bronchiolitis, were included in the study. Children in the group 1 were patients treated with salbutamol nebulization 0.15 mg/kg with 3 ml normal saline every six hourly. Children in the group 2 received adrenaline nebulization 0.1 ml/kg of 1:1000 dilutions with 3 ml normal saline every six hourly. Both the groups were given similar supportive management that included oxygen therapy, intravenous fluids, and antipyretics. Data was collected in the form of age, gender, heart rate, respiratory rate, SpO² and RDAI score at admission, 6hr, 24 hr and 48hr after admission, duration of hospital stay and duration of oxygen therapy. Results: Out of 66 patients, 38(57.6%) were male and 28(42%) were female. The mean with standard deviation of age in months was 20.45 + 12.9 in salbutamol group and 16.7 + 12.3 in adrenaline group (p value = 0.23). Mean with standard deviation of weight of patients was 9.7+ 3.5 in salbutamol group and 8.9+3.3 in adrenaline group (p value =0.34). Regarding the duration of hospital stay the mean and standard deviation of hospital stay was 4.2+ 0.9 in salbutamol group and 3.9 + 1 in adrenaline group with p value 0.016.  Mean and standard deviation of duration of oxygen therapy was 1.05+ 0.7 in salbutamol group and 0.9+0.4 in adrenaline group with p value 0.42. There was no significant difference in the values of RDAI, heart rate, respiratory rate, SPO² at admission and subsequently after 6hrs, 24hrs, and 48hrs. Conclusion: We concluded that there was a significant reduction in duration of hospital stay in patients who received adrenaline nebulization then those nebulized with salbutamol. RDAI scores in the initial 48 hours in both the groups were improved in successive readings, but there was no significant difference in RDAI scores between the two groups recorded at different time intervals.