肾上腺素的临床疗效喷雾外消旋沙丁胺醇在急性细支气管炎。

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Reijonen T, Korppi M, Pitkakangas年代,Tenhola年代,rem K

肾上腺素的临床疗效喷雾外消旋沙丁胺醇在急性细支气管炎。

地中海拱形Pediatr Adolesc。1995年6月,149 (6):686 - 92。

PubMed ID
7767427 (在PubMed
]
文摘

摘要目的:探讨是否喷雾外消旋肾上腺素或沙丁胺醇改善急性毛细支气管炎患儿呼吸窘迫。设计:一项随机,安慰剂对照,双盲研究。设置:一所大学医院提供主要的医院照顾所有的儿科患者在定义的区域。病人:一百连续24个月以下的婴儿送往医院进行治疗,在急性细支气管炎。干预:病人接受两个地吸入每隔30分钟:外消旋肾上腺素其次是生理盐水(代表集团;n = 24),沙丁胺醇其次是生理盐水(AP组;n = 27),生理盐水其次是外消旋肾上腺素(PRE组;n = 24)和生理盐水其次是沙丁胺醇(PA组;n = 25)。所有患者接受了肌内肾上腺素后60分钟的开始学习。 MAIN OUTCOME MEASURES: Oxygen saturation, respiratory rate, and two clinical scores were used: one based on wheezing and retractions (Respiratory Distress Assessment Instrument) and the other based on changes in wheezing, retractions, and respiratory rate (Respiratory Assessment Change Score). MAIN RESULTS: During the study, there were no significant differences among the four groups in clinical scores, oxygen saturations, and respiratory rates. Mean Respiratory Distress Assessment Instrument scores improved significantly within the REP, PRE, and AP groups 15 minutes after the first inhalation. In only the REP group, which received racemic epinephrine, the confidence limits did not overlap. A comparison of paired data of each patient revealed that the difference in Respiratory Assessment Change Score was significant between racemic epinephrine and physiologic saline, but not between albuterol and physiologic saline. Intramuscular epinephrine significantly improved Respiratory Distress Assessment Index scores in those groups treated earlier with racemic epinephrine (REP and PRE groups). No significant adverse effects were seen in any group or at any phase of the study. CONCLUSIONS: Elimination of hypoxia by supplemental oxygen and moistening of inspired air relieve the symptoms of acute bronchiolitis. Nebulized racemic epinephrine and albuterol are safe and useful in the treatment of acute bronchiolitis. Improvements in symptom scores at 15 minutes favor the use of racemic epinephrine. As the action of epinephrine is short, the effect can be increased by repeated inhalations.

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