Document Detail


Helium-oxygen therapy for infants with bronchiolitis: a randomized controlled trial.
MedLine Citation:
PMID:  22147778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare nebulized racemic epinephrine delivered by 70% helium and 30% oxygen or 100% oxygen followed by helium-oxygen inhalation therapy via high-flow nasal cannula (HFNC) vs oxygen inhalation via HFNC in the treatment of bronchiolitis.
DESIGN: Prospective, randomized, controlled, single-blind trial.
SETTING: This study was conducted from October 1, 2004, through May 31, 2008, in the emergency department of an urban, tertiary care children's hospital. Patients Infants aged 2 to 12 months with a Modified Wood's Clinical Asthma Score (M-WCAS) of 3 or higher.
INTERVENTIONS: Patients initially received nebulized albuterol treatment driven by 100% oxygen. Patients were randomized to the helium-oxygen or oxygen group and received nebulized racemic epinephrine via a face mask. After nebulization, humidified helium-oxygen or oxygen was delivered by HFNC. After 60 minutes of inhalation therapy, patients with an M-WCAS of 2 or higher received a second delivery of nebulized racemic epinephrine followed by helium-oxygen or oxygen delivered by HFNC. Main Outcome Measure Degree of improvement of M-WCAS for 240 minutes or until emergency department discharge.
RESULTS: Of 69 infants enrolled, 34 were randomized to the helium-oxygen group and 35 to the oxygen group. The mean change in M-WCAS from baseline to 240 minutes or emergency department discharge was 1.84 for the helium-oxygen group compared with 0.31 for the oxygen group (P < .001). The mean M-WCAS was significantly improved for the helium-oxygen group compared with the oxygen group at 60 minutes (P = .005), 120 minutes (P < .001), 180 minutes (P < .001), and 240 minutes (P < .001).
CONCLUSION: Nebulized racemic epinephrine delivered by helium-oxygen followed by helium-oxygen inhalation therapy delivered by HFNC was associated with a greater degree of clinical improvement compared with that delivered by oxygen among infants with bronchiolitis. Trial Registration clinicaltrials.gov Identifier: NCT00116584.
Authors:
In K Kim; Erin Phrampus; Kendra Sikes; John Pendleton; Al Saville; Timothy Corcoran; Ed Gracely; Shekhar Venkataraman
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  165     ISSN:  1538-3628     ISO Abbreviation:  Arch Pediatr Adolesc Med     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-07     Completed Date:  2012-01-26     Revised Date:  2012-05-29    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1115-22     Citation Subset:  AIM; IM    
Affiliation:
Division of Pediatric Emergency Medicine, Kosair Children's Hospital, 571 S Floyd St, Ste 300, Louisville, KY 40202, USA. in.kim@louisville.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00116584
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MeSH Terms
Descriptor/Qualifier:
Albuterol / administration & dosage,  therapeutic use
Bronchiolitis / therapy*
Bronchodilator Agents / administration & dosage,  therapeutic use
Chi-Square Distribution
Epinephrine / administration & dosage,  therapeutic use
Female
Helium / therapeutic use*
Humans
Humidity
Infant
Male
Nebulizers and Vaporizers
Oxygen Inhalation Therapy / methods*
Prospective Studies
Single-Blind Method
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 18559-94-9/Albuterol; 51-43-4/Epinephrine; 7440-59-7/Helium
Comments/Corrections
Comment In:
J Pediatr. 2012 May;160(5):883-4   [PMID:  22516333 ]
Arch Pediatr Adolesc Med. 2011 Dec;165(12):1137-8   [PMID:  22147783 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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