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 Vol. 22 No. 4, October 2009
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AAP Grand Rounds 22:40 (2009)
© 2009 American Academy of Pediatrics

SENIOR MEMBERS

Epi + Dex: Unexpected Therapeutic PERC for Bronchiolitis

Source: Plint AC, Johnson DW, Patel H, et al. Epinephrine and dexamethasone in children with bronchiolitis. N Engl J Med. 2009;360:2079–2089; doi:10.1056/NEJMoa0900544[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: In infants with bronchiolitis, is the combination of nebulized epinephrine and oral dexamethasone an effective treatment compared to either medication alone?

Question type: Intervention

Study design: Multicenter, double-blind, placebo-controlled study

 

Investigators from Pediatric Emergency Research Canada (PERC) conducted a double-blind, placebo-controlled trial in which infants with bronchiolitis seen in eight emergency departments (ED) were studied to determine the benefit of using both nebulized epinephrine and corticosteroids compared to placebo or either medication alone. Infants aged 6 weeks to 12 months with bronchiolitis who were seen between 2004 and 2007 were eligible for this study if they had a score of 4–15 on the respiratory distress assessment index (RDAI).1 The RDAI rates wheezing and respiratory distress on a scale from 0–17, with a score below 4 indicating a very mild illness, and a score above 15 very severe illness.

Bronchiolitis was . . . [Full Text of this Article]

Donald Schiff, MD, FAAP
University of Colorado School of Medicine and The Children’s Hospital, Denver, CO