Citation | Study group |
Study type (level of evidence) | Outcome | Key results | Comments |
Kellneret al (1996) | Wheeze <24 months. Looking at a range of bronchodilators (incl adrenaline) compared to placebo | Systematic review—most studies double blind RCTs (level 1a) | Clinical score | Slight improvement in bronchodilator group; RR = 0.76 (95% CI 0.6 to 0.95) | May have seen a slight improvement because of inclusion of recurrent wheezers |
Hospital admission | No difference; RR = 0.85 (95% CI 0.47 to 1.53) | ||||
Menon et al (1995) | 42 first time wheezers less than 12 months. Nebulised adrenaline cf nebulised salbutamol | Double blind RCT (level 1b) | Hospital admission | Significant difference 33% cf 81% admitted; NNT = 2 (95% CI 1 to 5) | Small study |
Oxygen saturation | Significantly higher in adrenaline group at 1 h (96%v 94%) | ||||
Reijonenet al (1995) | 100 consecutive wheezers less than 24 months admitted. Compared adrenaline, salbutamol and placebo (N saline) | Double blind RCT (level 1b) | Mean symptom score change using the Respiratory Distress Assessment Instrument (RDAI) | Significant between adrenaline and placebo (but not significant between salbutamol and placebo) | Included some recurrent wheezers |
Kristjansson et al (1993) | 29 infants (<18 months) with acute bronchiolitis. Adrenaline cf placebo | Double blind RCT (level 1b) | Symptom score | Significant improvement with adrenaline | Both groups included recurrent wheezers |
Oxygen saturation | Significant improvement with adrenaline | ||||
Sanchez et al (1993) | 24 infants <1 y, with first episode of bronchiolitis. Adrenaline cf salbutamol | Double blind crossover RCT (level 1b) | Clinical score | Significant improvement with adrenaline cf salbutamol; NNT = 4 (95% CI 3 to 7) | Mean age 4.6 months (±0.5). Patients sedated with chloral hydrate |
Pulmonary mechanics | Significant improvement with adrenaline cf salbutamol |