Efficacy of Salbutamol for Infants Bronchiolitis: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 XIONGYin-mei ,  GONGFang

Department of Neonatus, Yongchuan Hospital of Chongqing Medical University, Yongchuan 402160, China;

Corresponding?author：

GONGFang, Email: gflinda@163.com

Keywords：

Salbutamol; Bronchiolitis; Infant; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20160110

Video：

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Objective To systematically review the efficacy of salbutamol for infants with bronchiolitis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CBM, VIP, WanFang Data and CNKI were searched from inception to March 2016 to collect randomized controlled trials (RCTs) about salbutamol for infants with bronchiolitis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 20 RCTs, involving 1?735 patients were included. The results of meta-analysis showed that, compared with the control group, the salbutamol group had shorter cough relief time (MD= –1.44 d, 95%CI –1.93 to –0.95, P < 0.000?01), dyspnear relief time (MD= –0.87 d, 95%CI –1.17 to –0.56, P < 0.000?01), asthmatic remission time (MD= –1.38 d, 95%CI –1.93 to –0.83, P < 0.000?01), pulmonary rales disappear time (MD= –1.58 d, 95%CI –2.00 to –1.17, P < 0.000?01) and average hospitalization time (MD= –1.40 d, 95%CI –2.12 to –0.68, P=0.000?1), but could not improve clinical severity score (MD= –0.17, 95%CI –0.35 to 0.00, P=0.05). Conclusion Current evidence indicates that salbutamol can significantly improve the bronchiolitis with cough, dyspnea and wheezes symptoms and lung’s signs, shorten the length of hospital stay, but can not improve the clinical severity score of infants with bronchiolitis. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.

Citation： XIONGYin-mei, GONGFang. Efficacy of Salbutamol for Infants Bronchiolitis: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2016, 16(6): 712-718. doi: 10.7507/1672-2531.20160110 Copy

1.	?劉阿拉塔. 毛細支氣管炎診斷與治療的新進展. 世界最新醫學信息文摘, 2015, 15(85): 158-160.
2.	American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics, 2013, 118(4): 1774-1793.
3.	Castro-Rodriguez JA, Rodriguez-Martinez CE, Sossa-Brice?o MP. Principal findings of systematic reviews for the management of acute bronchiolitis in children. Paediatr Respir Rev, 2015, 16(4): 267-275.
4.	吳淑娟. 高滲鹽水聯合沙丁胺醇霧化吸入治療急性期毛細支氣管炎的Meta分析. 中國實用內科雜志, 2015, 35(S1): 136-137.
5.	周華, 吉山寶, 姜媛淵, 等. 高滲鹽水霧化吸入治療嬰幼兒毛細支氣管炎臨床隨機對照試驗Meta分析. 中國實用兒科雜志, 2015, 30(11): 842-847.
6.	《中華兒科雜志》編輯委員會, 中華醫學會兒科學分會呼吸學組. 毛細支氣管炎診斷、治療與預防專家共識(2014年版). 中華兒科雜志, 2015, 53(3): 168-171.
7.	范娟,李茂軍, 吳青, 等. 毛細支氣管炎的臨床管理—美國兒科學會臨床實踐指南簡介. 中華實用兒科雜志, 2015, 30(10): 730-732.
8.	Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 2014, 134(5): e1474-e1502.
9.	Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). [cited 2012 Jan 5]. Available at: http://www.cochrane-handbook.org.
10.	Gupta P, Aggarwal A, Sharma KK, et al. Oral salbutamol for symptomatic relief in mild bronchiolitis: A double blind randomized placebo controlled trial. Indian Pediatrics, 2008, 45(7): 547-553.
11.	吳俊峰. 沙丁胺醇聯合布地奈德霧化吸入治療小兒毛細支氣管炎的效果觀察. 河南醫學研究, 2015, 24(5): 39-40.
12.	吳勝偉, 韋柳春. 氧驅動霧化吸入沙丁胺醇治療毛細支氣管炎60例臨床觀察. 右江民族醫學院學報, 2009, 31(2): 236-237.
13.	李樹魚. 沙丁胺醇聯合西咪替丁輔助治療小兒毛細支氣管炎療效觀察. 河北醫藥, 2010, 32(16): 2214-2215.
14.	王紅. 沙丁胺醇壓縮霧化吸入佐治毛細支氣管炎31例療效觀察. 天津醫藥, 2002, 30(8): 512.
15.	胡夏, 邢雪燕. 沙丁胺醇(萬托林)霧化吸入佐治毛細支氣管炎32例療效觀察. 兒科藥學雜志, 2004, 10(6): 37-38.
16.	李紅梅, 孫麗. 硫酸沙丁胺醇聯合氨溴索霧化治療小兒毛細支氣管炎效果觀察. 寧夏醫科大學學報, 2012, 34(12): 1328-1329.
17.	郭丹萍. 硫酸沙丁胺醇溶液氣泵吸入治療小兒毛細支氣管炎臨床觀察. 數理醫藥學雜志, 2008, 21(6): 680-681.
18.	劉廣俊. 沙丁胺醇霧化吸入治療毛細支氣管炎的療效觀察. 右江醫學, 2008, 36(4): 438-439.
19.	陳燦華, 丁嫻, 高風, 等. 不同方法治療毛細支氣管炎的臨床差異性分析. 醫學理論與實踐, 2008, 21(12): 1419-1421.
20.	李徽. 沙丁胺醇吸入療法治療嬰幼兒毛細支氣管炎后喘息56例療效分析. 中國現代藥物應用, 2010, 4(3): 140-141.
21.	韓世良. 沙丁胺醇治療毛細支氣管炎療效觀察. 現代醫院, 2010, 10(z2): 52-53.
22.	韓應魁, 舒喘靈輔助治療小兒毛細支氣管炎128例療效觀察. 青海醫藥雜志, 2015, 45(7): 31.
23.	Patel H, Platt RW, Pekeles GS, et al. A randomized, controlled trial of the effectiveness of nebulized therapy with epinephrine compared with albuterol and saline in infants hospitalized for acute viral bronchiolitis. J Pediatr, 2002, 141(6): 818-824.
24.	Patel H, Gouin S, Platt RW. Randomized, double-blind, placebo-controlled trial of oral albuterol in infants with mild-to-moderate acute viral bronchiolitis. J Pediatr, 2003, 142(5): 509-514.
25.	Anil AB, Anil M, Saglam AB, et al. High volume normal saline alone is as effective as nebulized salbutamol-normal saline, epinephrine-normal saline, and 3% saline in mild bronchiolitis. Pediatr Pulmonol, 2010, 45(1): 41-47.
26.	Cengizlier R, Saraclar Y, Adalioglo G, et al. Effect of oral and inhaled salbutamol in infants with bronchiolitis. Acta paediatrica Jpn; Overseas edition, 1997, 39(1): 61-63.
27.	Ipek IO, Yalcin EU, Sezer G, et al. The efficacy of nebulized salbutamol, hypertonic saline and salbutamol/hypertonic saline combination in moderate bronchiolitis. Pulm Pharmacol Ther, 2011, 24(6): 633-637.
28.	Gadomski AM, Aref GH, Din OB, et al. Efficacy of albuterol in the management of bronchiolitis. Pediatrics, 1994, 93(6 Pt 1): 907-912.
29.	Khashabi J, Salari LS, Karamiyar M, et al. Comparison of the efficacy of nebulized L-epinephrine, salbutamol and normal saline in acute bronchiolitis: A randomized clinical trial. Medical Journal of the Islamic Republic of Iran, 2005, 19(2): 119.
30.	Gadomski AM, Scribani MB, Bronchodilators for bronchiolitis. Cochrane Database Syst Rev, 2014, 6: CD001266.

1. ?劉阿拉塔. 毛細支氣管炎診斷與治療的新進展. 世界最新醫學信息文摘, 2015, 15(85): 158-160.
2. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics, 2013, 118(4): 1774-1793.
3. Castro-Rodriguez JA, Rodriguez-Martinez CE, Sossa-Brice?o MP. Principal findings of systematic reviews for the management of acute bronchiolitis in children. Paediatr Respir Rev, 2015, 16(4): 267-275.
4. 吳淑娟. 高滲鹽水聯合沙丁胺醇霧化吸入治療急性期毛細支氣管炎的Meta分析. 中國實用內科雜志, 2015, 35(S1): 136-137.
5. 周華, 吉山寶, 姜媛淵, 等. 高滲鹽水霧化吸入治療嬰幼兒毛細支氣管炎臨床隨機對照試驗Meta分析. 中國實用兒科雜志, 2015, 30(11): 842-847.
6. 《中華兒科雜志》編輯委員會, 中華醫學會兒科學分會呼吸學組. 毛細支氣管炎診斷、治療與預防專家共識(2014年版). 中華兒科雜志, 2015, 53(3): 168-171.
7. 范娟,李茂軍, 吳青, 等. 毛細支氣管炎的臨床管理—美國兒科學會臨床實踐指南簡介. 中華實用兒科雜志, 2015, 30(10): 730-732.
8. Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 2014, 134(5): e1474-e1502.
9. Higgins JP, Green S. Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0). [cited 2012 Jan 5]. Available at: http://www.cochrane-handbook.org.
10. Gupta P, Aggarwal A, Sharma KK, et al. Oral salbutamol for symptomatic relief in mild bronchiolitis: A double blind randomized placebo controlled trial. Indian Pediatrics, 2008, 45(7): 547-553.
11. 吳俊峰. 沙丁胺醇聯合布地奈德霧化吸入治療小兒毛細支氣管炎的效果觀察. 河南醫學研究, 2015, 24(5): 39-40.
12. 吳勝偉, 韋柳春. 氧驅動霧化吸入沙丁胺醇治療毛細支氣管炎60例臨床觀察. 右江民族醫學院學報, 2009, 31(2): 236-237.
13. 李樹魚. 沙丁胺醇聯合西咪替丁輔助治療小兒毛細支氣管炎療效觀察. 河北醫藥, 2010, 32(16): 2214-2215.
14. 王紅. 沙丁胺醇壓縮霧化吸入佐治毛細支氣管炎31例療效觀察. 天津醫藥, 2002, 30(8): 512.
15. 胡夏, 邢雪燕. 沙丁胺醇(萬托林)霧化吸入佐治毛細支氣管炎32例療效觀察. 兒科藥學雜志, 2004, 10(6): 37-38.
16. 李紅梅, 孫麗. 硫酸沙丁胺醇聯合氨溴索霧化治療小兒毛細支氣管炎效果觀察. 寧夏醫科大學學報, 2012, 34(12): 1328-1329.
17. 郭丹萍. 硫酸沙丁胺醇溶液氣泵吸入治療小兒毛細支氣管炎臨床觀察. 數理醫藥學雜志, 2008, 21(6): 680-681.
18. 劉廣俊. 沙丁胺醇霧化吸入治療毛細支氣管炎的療效觀察. 右江醫學, 2008, 36(4): 438-439.
19. 陳燦華, 丁嫻, 高風, 等. 不同方法治療毛細支氣管炎的臨床差異性分析. 醫學理論與實踐, 2008, 21(12): 1419-1421.
20. 李徽. 沙丁胺醇吸入療法治療嬰幼兒毛細支氣管炎后喘息56例療效分析. 中國現代藥物應用, 2010, 4(3): 140-141.
21. 韓世良. 沙丁胺醇治療毛細支氣管炎療效觀察. 現代醫院, 2010, 10(z2): 52-53.
22. 韓應魁, 舒喘靈輔助治療小兒毛細支氣管炎128例療效觀察. 青海醫藥雜志, 2015, 45(7): 31.
23. Patel H, Platt RW, Pekeles GS, et al. A randomized, controlled trial of the effectiveness of nebulized therapy with epinephrine compared with albuterol and saline in infants hospitalized for acute viral bronchiolitis. J Pediatr, 2002, 141(6): 818-824.
24. Patel H, Gouin S, Platt RW. Randomized, double-blind, placebo-controlled trial of oral albuterol in infants with mild-to-moderate acute viral bronchiolitis. J Pediatr, 2003, 142(5): 509-514.
25. Anil AB, Anil M, Saglam AB, et al. High volume normal saline alone is as effective as nebulized salbutamol-normal saline, epinephrine-normal saline, and 3% saline in mild bronchiolitis. Pediatr Pulmonol, 2010, 45(1): 41-47.
26. Cengizlier R, Saraclar Y, Adalioglo G, et al. Effect of oral and inhaled salbutamol in infants with bronchiolitis. Acta paediatrica Jpn; Overseas edition, 1997, 39(1): 61-63.
27. Ipek IO, Yalcin EU, Sezer G, et al. The efficacy of nebulized salbutamol, hypertonic saline and salbutamol/hypertonic saline combination in moderate bronchiolitis. Pulm Pharmacol Ther, 2011, 24(6): 633-637.
28. Gadomski AM, Aref GH, Din OB, et al. Efficacy of albuterol in the management of bronchiolitis. Pediatrics, 1994, 93(6 Pt 1): 907-912.
29. Khashabi J, Salari LS, Karamiyar M, et al. Comparison of the efficacy of nebulized L-epinephrine, salbutamol and normal saline in acute bronchiolitis: A randomized clinical trial. Medical Journal of the Islamic Republic of Iran, 2005, 19(2): 119.
30. Gadomski AM, Scribani MB, Bronchodilators for bronchiolitis. Cochrane Database Syst Rev, 2014, 6: CD001266.

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