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Just did your conference – fantastic!!!
Took up the advice from your mentor and looked up the NNT website. While perusing through it noticed a Green light for the use of andrenaline for bronchiolitis. This option was not mentioned in yesterdays talk – I presume you are aware of this option. What do you think?
Claire talked about adrenaline in the setting of asthma. In bronchiolitis the same issues of lactic acidosis can occur. My take is that you can use it, but it probably isn’t better than placebo. The Cochrane Collaborative review (2011), concluded that adrenaline may decrease admissions of bronchiolitis and can be used in the first 24 hours, but there is no evidence that multiple doses assist and overall the studies weren’t great. A NEJM article June 2013, found no difference between adrenaline and placebo. I think you can give it, as long as you don’t give multiple doses. Does it work? Maybe? Maybe not. A small trend in improvement in older children? When associated with steroids this may change, but no good studies yet.
When is next airway course ?
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