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| |  AAP: Ipratropium Beats Albuterol and Saline for Treatment of Bronchiolitis in Children By Alison Palkhivala Special to DG News SAN FRANCISCO, CA -- October 25, 2001 -- A head-to-head comparison reveals that ipratropium bromide is more effective than either albuterol sulfate or saline for the treatment of bronchiolitis in infants in an emergency care setting. When infants arrive at the emergency ward with symptoms of wheezing, a number of treatments are available for use but, their relative efficacies and safeties have not been compared directly. Srinivasian Suresh, MD, from the department of pediatrics at the Children's Hospital of Michigan, Detroit, Michigan, United States, presented his latest findings here this week at the National Conference and Exhibition of the American Academy of Pediatrics (AAP) on ipratropium vs. albuterol vs. saline for this indication. For this double-blind, prospective study, 72 infants (aged six weeks to 18 months) presenting to the Children’s Hospital of Michigan emergency department with a first episode of wheezing were randomized to receive 3 ml of nebulized ipratropium 0.25 mg (n=24), albuterol 2.5 mg (n=24), or saline (n=24), each of which were administered with 10 L of oxygen over 10 minutes. Overall, ipratropium emerged as the significantly more effective therapy. In those given ipratropium, mean respiratory rate (RR) decreased by 9.33 breaths, compared to 3.42 in the albuterol group, and 1.33 in the saline group. Similarly mean respiratory assessment score (RAS) decreased in the ipratropium group by 1.75 points, compared to 0. 96 in the albuterol group, and 0.58 in the saline group. Differences in changes in RR and RAS were significant when comparing the ipratropium group to the albuterol and saline groups, but the differences between the albuterol and saline groups themselves did not reach statistical significance. Heart rate increased by an average of 12 beats per minute in the albuterol group. Similar effects were not seen in those treated with ipratropium or saline. Dr. Suresh concludes, therefore, that ipratropium comes out the winner in this study.
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