Evaluation of Three Doses of Nebulized Epinephrine in Post-Extubation Croup
In infants and children experiencing post-extubation stridor, is a 0.5, 2.5 or 5ml dose of Nebulized L-Epinephrine more effective in reducing stridor (Westley score)? A Prospective Randomized Double-Blind Study
Paulo Sergio Lucas da Silva
72 participants
Oct 1, 2010
Interventional
Conditions
Summary
Although the use of nebulized epinephrine has been well studied and has a long history of use in children with viral croup, there is a few prospective studies investigating the effect of epinephrine on postextubation croup. However, there is no consensus in the literature regarding the appropriate dose of nebulized 1:1000 l-adrenaline that should be used to preventing postextubation croup. The aim of this study is to compare the effectiveness and safety of nebulized l-epinephrine at dosage of 0.5 mL, 2.5 mL and 5 mL in the treatment of postextubation stridor
Eligibility
Inclusion Criteria1
- Patients presenting hoarseness, a barking cough and inspiratory stridor after extubation and a Westley score more than 3.
Exclusion Criteria1
- Previous history of subglottic stenosis, laryngomalacia, infectious croup or use of corticosteroids within 48 hours prior to extubation
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Interventions
Intervention:nebulized l-epinephrine (1:1000) Doses: 0.5 mL or 2.5 mL or 5 mL Mode of administration: nebulization by face mask Duration: 15 minutes Patients will be assigened to one of three study treatments at 15 minutes post-extubation: 5 mL of l-adrenaline 1:1000 (group 1), 2.5 mL of l-adrenaline 1:1000 (group 2) or 0.5 mL of l-adrenaline 1:1000 (group 3). If the amount of l-epinephrine was less than 5 mL, isotonic saline was added until the volume achieved 5 mL. Research nurse will administer nebulizations over 15 minutes with a small, tight-fitting plastic face mask with an updraft nebulizer (Hudson RCI, Teleflex Medical, USA) connected to a source of pressurized oxygen with continuous flow of 100% oxygen at 5 L/min. The nebulizers will be administered until empty.
Locations(1)
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ACTRN12610000759099