TERBUTALINE VS ALBUTEROL FOR OUT-OF-HOSPITAL RESPIRATORY-DISTRESS - RANDOMIZED, DOUBLE-BLIND TRIAL

Objective: To determine the efficacy and safety of single doses of sub cutaneous terbutaline (TERB) Or nebulized albuterol (ALE) during out-o f-hospital treatment for respiratory distress from asthma or chronic o bstructive pulmonary disease. Methods: Patients aged > 18 years who ha d respiratory distress were enrolled in a double-placebo, double-blind , randomized trial. Paramedics measured respiratory severity using an empiric score [respiratory rate, wheezing, speech, and peak expiratory flow rate (PEFR)], and the patients rated their own respiratory distr ess using a visual analog scale (VAS). The patients received O-2 plus ALE (2.5 mg) and saline injection (n = 40) or TERB (0.25 mg) and salin e aerosol (n = 43). Results: The groups were similar with respect to a ge, gender, initial empiric scores (median score 9 for both groups), P EFRs (89 +/- 84 L/min, mean +/- SD, for ALE vs 97 +/- 84 L/min for TER B), and respiratory distress VAS scores. Both groups showed significan t improvement in their respiratory distress VAS scores by the time of ED arrival. The ALE group had a greater improvement in respiratory dis tress VAS score than did the TERB group (p < 0.05). Empiric scores, PE FR scores, and hospital admission frequencies were not significantly d ifferent. No complication was observed. Conclusion: The out-of-hospita l administration of either aerosolized ALE or subcutaneous TERB reduce d respiratory severity. Albuterol provided greater subjective improvem ent in respiratory distress.