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Am J Emerg Med. 2006 Mar;24(2):217-22.

Comparison between nebulized adrenaline and beta2 agonists for the treatment of acute asthma. A meta-analysis of randomized trials.

Author information

  • 1Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Uruguay. gurodrig@adinet.com

Abstract

OBJECTIVE:

To evaluate the efficacy of aerosolized adrenaline compared to inhaled beta(2) agonists in the treatment of acute asthma in the emergency setting.

DATA SOURCES:

MEDLINE, EMBASE, CINAHI, and Cochrane databases, review articles, and references of included trials.

REVIEW METHODS:

Published (1966-2005) randomized controlled trials with pulmonary function as primary outcome.

RESULTS:

Six studies met the criteria for inclusion in the meta-analysis. They included 161 adults and 121 children and adolescents. Patients who received inhaled adrenaline showed a nonsignificant improvement in pulmonary function (standardized mean difference = 0.20, 95% confidence interval -0.22 to 0.63, P = .35) compared to patients getting inhaled beta(2) agonists. Moderate heterogeneity was identified between studies (I(2) = 47.2%). Homogeneity was achieved when studies that reported pulmonary function were stratified by intensity of adrenaline treatment. The use of more than 2 mg of adrenaline per dose was equivalent to 5 mg of salbutamol or terbutaline per dose. On the contrary, 2 mg or less of adrenaline per dose was inferior to 2.5 or 5 mg of salbutamol per dose. In addition, there were no differences in heart rate and Pao(2) between treatments.

CONCLUSIONS:

There was no statistically significant benefit of nebulized adrenaline over salbutamol or terbutaline in the treatment of children and adults with moderate-severe acute asthma.

PMID:
16490653
DOI:
10.1016/j.ajem.2005.10.008
[PubMed - indexed for MEDLINE]
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