COMPARISON OF INHALED NEBULIZED ADRENALINE WITH SALBUTAMOL IN ACUTE ASTHMA

Objective: In asthma, mucosal oedema could be an important component o f airway obstruction. Treating asthmatic children with a combined beta and alpha receptors agonist seems to be a logical therapeutic approac h. The main purpose of this study is to compare inhaled nebulised adre naline with salbutamol in asthmatic children. Methods: All patients ha d previously been diagnosed as asthmatic. Requirements for entry into the study were an acute asthmatic attack lasting for longer than 1 hou r and no bronchodilator therapy for the previous 3 hours. The patients ages were comprised between 5 and 15 years. Baseline measurement of h eart rate, blood pressure, peak expiratory flow and arterial oxygen sa turation by pulse oximetry were made and scored every 15 minutes for 6 0 minutes. Arterial blood gases were measured with patients breathing room air. Patients were then randomised to be given either Salbutamol (0.03 ml/kg of the 5 mg/ml solution) or adrenaline (1 mg/kg). Both sol utions were administered for 20 minutes through a nebuliser with conti nuous flow of oxygen of 6 to 8 L/min. Heart rate, blood pressure, satu ration by pulse oximetry and peak expiratory flow were measured at 15 minutes intervals after nebulisation for 60 minutes. Arterial blood ga ses were measured before and after nebulisation. Results: All patients showed an increase in peak expiratory flow and saturation by pulse ox imetry after nebulisation. There was no significant difference between treatment groups over time. Heart rate fell after nebulised salbutamo l and adrenaline. There was no change in blood pressure after either n ebuliser. Conclusion: These results suggest that nebulised adrenaline is as effective as a nebulised beta agonist in acute asthma and is wit hout significant cardiovascular side effects.