Background: Bronchiolitis is a short term viral inflammation of bronchioles in the lower respiratory tract associated with substantial morbidity in young children. There is conflicting evidence regarding the effectiveness of bronchodilators in the management of bronchiolitis.

Objectives:  The main objectives of the current study were comparing the effectiveness of nebulized epinephrine and salbutamol in infants suffering with bronchiolitis.

Methodology: This 6 months study was conducted in the Department of Pediatrics, Khyber Teaching Hospital Peshawar, Pakistan between March and August 2011. The study design was randomized controlled trial. A total of 90 children of less than 1 year age were randomly and equally allocated in two groups, each group had 45 patients. Infants in group A were given nebulized salbutamol (0.15 mg/kg) and group B received nebulized epinephrine (0.1 mL/kg) (1:1000). The nebulisation was given in normal saline with an interval of 20 minutes for three times. Modified respiratory distress assessment instrument score; a globally recognized scale was used for disease assessment.  

Results: The mean mRDAI score before administration of salbutamol and epinephrine was 18.2 + 0.5 and 17.8 + 2.7 (p = 0.33) respectively which was reduced to 6.1 + 1.3 and 7.5 + 1.0 after treatment with salbutamol and epinephrine respectively (p = 0.001). The oxygen saturation in salbutamol and epinephrine groups before treatment 92.6 + 3.4  and 93.2 + 5.2 respectively improved to 96.4 + 1.5 and 97.1 + 0.8 respectively (p = 0.007). The respiratory rate before administration of salbutamol and epinephrine was 69 + 7 and 66 + 6 reduced to 55 + 4 and 49 + 4 (p = 0.001). The effect of both drugs caused relative increase in heart rate from 105  BPM + 4 to 130 BPM + 5 in salbutamol group while in case of epinephrine it increased from  102 BPM + 9 to 151 BPM + 5 (p = 0.001).

Conclusion: Nebulized epinephrine caused a significant decrease in the symptoms of bronchiolitis as compared to the symptoms recorded in infant received nebulized salbutamol.

Keywords: Acute Bronchiolitis, Epinephrine, Salbutamol