Rational drug use for acute bronchiolitis in emergency care

Özet

Despite the large variety of inhaled treatment options of acute bronchiolitis,there is no generally agreed treatment regime. This study aimed to determinethe most appropriate treatment option. This was a double-blind randomizedprospective clinical trial and has been performed in emergency department. Themean age of the 378 infants included in the study was 7.63 ± 4.6 months,and 54.8% (207) were boys. Patients were randomized by using the lotterymethod for simple random sample into 5 different treatment options; 3%hypertonic saline, nebulized adrenaline, nebulized adrenaline mixed with 3%hypertonic saline, nebulized salbutamol, and as control group; normal saline(0.9% NaCl). From the first treatment time until discharge time; treatmentdurations, adverse events and readmission rates within the first fifteendays were recorded for each patient. Nebulized adrenaline mixed with 3%hypertonic saline, as compared with other options, were associated with asignificantly higher discharge rate at 4th hours (p<0.001) and shorter lengthof hospital stay (p=0.039). However, there was no significant differencebetween options with regard to adverse events, discharge rates at 24thhours, and readmission rates within the first fifteen days. The superiority ofdischarge rates at 4 hours of nebulized adrenaline mixed with 3% hypertonicsaline, was evaluated as ‘better acute response’ and can be helpful to reducehospitalization needs. Additionally, this option seems to be more effective toreduce length of hospital stay.