Comparative efficacy of combined nebulized salbutamol with ipratropium bromide and nebulized adrenaline to treat children with acute bronchiolitis

Abstract

As the efficacy of combined nebulized salbutamol & ipratropium bromide as well as L-adrenaline to treat acute bronchiolitis is not well studied among the Bangladeshi infants, this study was carried out to see their efficacy in acute bronchiolitis and to compare their effectiveness. This randomized clinical trial was done among 60 children aged less than 02 years, admitted in the department of Pediatrics, Dhaka Medical College Hospital, during January through December 2005 with acute bronchiolitis. After a quick initial assessment, nebulization were done twice at 6 hours interval with the mentioned drugs, group wise (one group with salbutamol plus ipratropium bromide and other group with L-adrenaline alone) and the outcomes were assessed after 30 minutes of each nebulization in respect to oxygen saturation and clinical modified respiratory distress assessment instrument (MRDAI) scores. The results were analyzed by using SPSS version 10.0 and at a p value of </=0.05, the test was considered significant. The clinical characteristics were similar in both the groups. After 02 doses of nebulizations by the studied drugs, a significant improvement in respect to oxygen saturation and MRDAI score were noted among the children in both the groups, compared to their baseline status (p=0.000). However, L-adrenaline showed more efficacy (MRDAI, p=0.021; SaO2, p=0.034) than combined Salbutamol & Ipratropium bromide. Both L-adrenaline and combined salbutamol & ipratropium bromide were found effective in acute bronchiolitis but L-adrenaline was found more effective. A large multi-centre clinical trial is recommended.