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Arch Pediatr Adolesc Med. 2004;158:403.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We believe that a critical issue has been missed in the articles of Hartling et al¹ and Christakis and Lehmann² about epinephrine and the treatment of bronchiolitis. Both articles considered studies involving children younger than 2 years, which meets the North American definition of bronchiolitis; however, bronchiolitis morbidity and finding an effective treatment concern mainly infants (younger than 1 year).

The newborn's lungs move through important changes from birth to 2 years of age. The proper fetal period of lung development, with the end being the saccular stage, is close to 6 months of age, and the alveolar-arterial ratio of 20:1 in the newborn changes to 12:1 at 2 years of age, which is closer to the ratio for older children of 10:1.

For this reason, studies involving patients older than 1 year may have an increased chance of showing efficacy of treatment. The 2000 Cochrane Review³ about the use . . . [Full Text of this Article]

Egidio Barbi, MD
Trieste, Italy

Elena Neri, MD
Trieste, Italy

Alessandro Ventura, MD
Trieste, Italy

Corresponding author: Egidio Barbi, MD, Clinica Pediatrica, Istituto per l'Infanzia Burlo Garofolo, University of Trieste, Via dell'Istria 65/1, 34100 Trieste, Italy (e-mail: ebarbi@libero.it).

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Arch Pediatr Adolesc Med. 2004;158(4):403.
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