 |
|
The Efficacy of Nebulized Metaproterenol in Wheezing Infants and Young Children
Anthony J. Alario, MD;
William J. Lewander, MD;
Penelope Dennehy, MD;
Ronald Seifer, PhD;
Anthony L. Mansell, MD
Am J Dis Child. 1992;146(4):412-418.
Abstract
• The benefit of β-adrenergic agonists in the treatment of acutely wheezing infants and young children has not been well documented in the outpatient setting. To determine the efficacy of nebulized metaproterenol sulfate, 74 children aged 36 months or younger with acute wheezing participated in a double-masked, randomized, placebo-controlled clinical trial. Children received nebulized metaproterenol, either as an initial treatment or after a control treatment with normal saline solution. At baseline and 20 minutes after each treatment, an assessment was made that included measurements of heart rate, respiratory rate, oxygen saturation, and clinical variables related to respiratory compromise with the use of a standardized respiratory distress index (RDI). Children who received saline solution as initial therapy had no significant differences from baseline in any of the assessment measures. After metaproterenol therapy, children demonstrated an increase in heart rate ([mean±SD] 147±14 beats per minute vs 153±16 beats per minute), a decrease in respirations (50/min±5/min vs 45/min±7/min), improvement (lower scores) on the RDI (24±4 vs 15±2), and an increase in oxygen saturation (94.1%±2.7% vs 95.3%±3.0%). Patients aged 12 months or younger (n = 37) benefited from metaproterenol treatment (improvement in respiratory rate and RDI) but not to the same degree as children aged 24 months or older (n = 23) (improvement in respiratory rate, RDI, and oxygen saturation). Compared with assessments made before metaproterenol treatment, patients with respiratory syncytial virus infection (n = 21) had improvement in respirations (52/min±7/min vs45/min±6/min) and RDI scores (22±4 vs 14±3). Based on a priori criteria (reduction in a premedication respiratory rate of 20% and an RDI score of 50%), responders to metaproterenol therapy included 45% of the entire sample and, respectively, 40% of those aged 12 months or younger, 52% of those aged 24 months or older, and 48% of patients who tested positive for respiratory syncytial virus. Although there appears to be an age-dependent degree of response, metaproterenol is effective in relieving the respiratory distress of young acutely wheezing children, including those with documented respiratory syncytial virus bronchiolitis.
(AJDC. 1992;146:412-418)
Author Affiliations
From the Department of Pediatrics (Drs Alario, Lewander, Dennehy, and Mansell) and the Department of Psychiatry and Human Behavior (Dr Seifer), Brown University School of Medicine, Providence, RI.
Footnotes
Accepted for publication October 18, 1991.
Presented in part at the 30th Annual Meeting of the Ambulatory Pediatric Association, Anaheim, Calif, May 11, 1990.
Reprint requests to Department of Pediatrics, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903 (Dr Alario).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Diagnosis and Management of Bronchiolitis
Subcommittee on Diagnosis and Management of Bronch
Pediatrics 2006;118:1774-1793.
ABSTRACT
| FULL TEXT
Bronchodilation in infants with malacia or recurrent wheeze
Hofhuis et al.
Arch. Dis. Child. 2003;88:246-249.
ABSTRACT
| FULL TEXT
Bronchiolitis Management Preferences and the Influence of Pulse Oximetry and Respiratory Rate on the Decision to Admit
Mallory et al.
Pediatrics 2003;111:e45-e51.
ABSTRACT
| FULL TEXT
Effect of Practice Variation on Resource Utilization in Infants Hospitalized for Viral Lower Respiratory Illness
Willson et al.
Pediatrics 2001;108:851-855.
ABSTRACT
| FULL TEXT
Efficacy of Recombinant Human Deoxyribonuclease I in the Hospital Management of Respiratory Syncytial Virus Bronchiolitis
Nasr et al.
Chest 2001;120:203-208.
ABSTRACT
| FULL TEXT
The Use of Albuterol in Hospitalized Infants With Bronchiolitis
Dobson et al.
Pediatrics 1998;101:361-368.
ABSTRACT
| FULL TEXT
|
