Heliox-Driven Racemic Epinephrine in Treatment of Bronchiolitis in Pediatric ED Patients

• Status: Completed
• Trial end date: 2011-10-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to assess whether children with moderate to severe bronchiolitis treated with standard racemic epinephrine therapy via 70:30 helium-oxygen (heliox) driven nebulization will have improvements in measurements of airway more rapidly than those treated with conventional air-oxygen driven nebulization.

• Phase: Phase 3
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: University of Louisville
• Treatments: Epinephrine; Epinephryl borate; Racepinephrine

Criteria

Inclusion Criteria:

• Any child 2-12 months old seen in the emergency department.

• A clinical bronchiolitis score > 3 by modified Wood's Clinical Bronchiolitis Score (M-WCBS).

• Diagnostic criteria of bronchiolitis includes tachypnea, cough, prolonged expiratory phase, wheezing, rales, chest retractions, and hyperinflation of lungs on chest radiograph. After consenting a patient to the study, respiratory syncytial virus (RSV) infection will be tested by rapid enzyme-linked immunoabsorbent assay of nasal secretions.

Exclusion Criteria:

• No child will be excluded based on race or gender

• Patients under the age of 2 months or greater than 12 months

• Patients with cyanotic heart disease

• Patients with lobar pneumonia, defined by results of chest radiographs.

• The presence of interstitial disease or diffuse patchy marking consistent with atelectasis on chest radiographs will not exclude patients.

• Patients with croup.

• Patients with foreign body aspiration.

• Patients with history of cystic fibrosis, bronchopulmonary dysplasia or other chronic lung disease.

• Patients with liver or renal disease.

• Patients with sickle cell anemia.

• Patients requiring mechanical ventilation.

• Patients who develop supraventricular tachycardia secondary to racemic epinephrine administration.

• Patients with tracheomalacia or bronchomalacia.

• Patients who had received bronchodilators within 2 hours of initiation of the study.

• Patients who had received systemic corticosteroids within 72 hours of enrollment

• Patients who suffered from persistent airway hyperreactivity in the 3 months before the study.

• Patients who do not tolerate the nasal cannulae for 45 out of 60 minutes.