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.	刘阿拉塔. 毛细支气管炎诊断与治疗的新进展. 世界最新医学信息文摘, 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-Briceño MP. Principal findings of systematic reviews for the management of acute bronchiolitis in children. Paediatr Respir Rev, 2015, 16(4): 267-275.
4.	吴淑娟. 高渗盐水联合沙丁胺醇雾化吸入治疗急性期毛细支气管炎的Meta分析. 中国实用内科杂志, 2015, 35(S1): 136-137.
5.	周华, 吉山宝, 姜媛渊, 等. 高渗盐水雾化吸入治疗婴幼儿毛细支气管炎临床随机对照试验Meta分析. 中国实用儿科杂志, 2015, 30(11): 842-847.
6.	《中华儿科杂志》编辑委员会, 中华医学会儿科学分会呼吸学组. 毛细支气管炎诊断、治疗与预防专家共识(2014年版). 中华儿科杂志, 2015, 53(3): 168-171.
7.	范娟,李茂军, 吴青, 等. 毛细支气管炎的临床管理—美国儿科学会临床实践指南简介. 中华实用儿科杂志, 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.	吴俊峰. 沙丁胺醇联合布地奈德雾化吸入治疗小儿毛细支气管炎的效果观察. 河南医学研究, 2015, 24(5): 39-40.
12.	吴胜伟, 韦柳春. 氧驱动雾化吸入沙丁胺醇治疗毛细支气管炎60例临床观察. 右江民族医学院学报, 2009, 31(2): 236-237.
13.	李树鱼. 沙丁胺醇联合西咪替丁辅助治疗小儿毛细支气管炎疗效观察. 河北医药, 2010, 32(16): 2214-2215.
14.	王红. 沙丁胺醇压缩雾化吸入佐治毛细支气管炎31例疗效观察. 天津医药, 2002, 30(8): 512.
15.	胡夏, 邢雪燕. 沙丁胺醇(万托林)雾化吸入佐治毛细支气管炎32例疗效观察. 儿科药学杂志, 2004, 10(6): 37-38.
16.	李红梅, 孙丽. 硫酸沙丁胺醇联合氨溴索雾化治疗小儿毛细支气管炎效果观察. 宁夏医科大学学报, 2012, 34(12): 1328-1329.
17.	郭丹萍. 硫酸沙丁胺醇溶液气泵吸入治疗小儿毛细支气管炎临床观察. 数理医药学杂志, 2008, 21(6): 680-681.
18.	刘广俊. 沙丁胺醇雾化吸入治疗毛细支气管炎的疗效观察. 右江医学, 2008, 36(4): 438-439.
19.	陈灿华, 丁娴, 高风, 等. 不同方法治疗毛细支气管炎的临床差异性分析. 医学理论与实践, 2008, 21(12): 1419-1421.
20.	李徽. 沙丁胺醇吸入疗法治疗婴幼儿毛细支气管炎后喘息56例疗效分析. 中国现代药物应用, 2010, 4(3): 140-141.
21.	韩世良. 沙丁胺醇治疗毛细支气管炎疗效观察. 现代医院, 2010, 10(z2): 52-53.
22.	韩应魁, 舒喘灵辅助治疗小儿毛细支气管炎128例疗效观察. 青海医药杂志, 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. 刘阿拉塔. 毛细支气管炎诊断与治疗的新进展. 世界最新医学信息文摘, 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-Briceño MP. Principal findings of systematic reviews for the management of acute bronchiolitis in children. Paediatr Respir Rev, 2015, 16(4): 267-275.
4. 吴淑娟. 高渗盐水联合沙丁胺醇雾化吸入治疗急性期毛细支气管炎的Meta分析. 中国实用内科杂志, 2015, 35(S1): 136-137.
5. 周华, 吉山宝, 姜媛渊, 等. 高渗盐水雾化吸入治疗婴幼儿毛细支气管炎临床随机对照试验Meta分析. 中国实用儿科杂志, 2015, 30(11): 842-847.
6. 《中华儿科杂志》编辑委员会, 中华医学会儿科学分会呼吸学组. 毛细支气管炎诊断、治疗与预防专家共识(2014年版). 中华儿科杂志, 2015, 53(3): 168-171.
7. 范娟,李茂军, 吴青, 等. 毛细支气管炎的临床管理—美国儿科学会临床实践指南简介. 中华实用儿科杂志, 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. 吴俊峰. 沙丁胺醇联合布地奈德雾化吸入治疗小儿毛细支气管炎的效果观察. 河南医学研究, 2015, 24(5): 39-40.
12. 吴胜伟, 韦柳春. 氧驱动雾化吸入沙丁胺醇治疗毛细支气管炎60例临床观察. 右江民族医学院学报, 2009, 31(2): 236-237.
13. 李树鱼. 沙丁胺醇联合西咪替丁辅助治疗小儿毛细支气管炎疗效观察. 河北医药, 2010, 32(16): 2214-2215.
14. 王红. 沙丁胺醇压缩雾化吸入佐治毛细支气管炎31例疗效观察. 天津医药, 2002, 30(8): 512.
15. 胡夏, 邢雪燕. 沙丁胺醇(万托林)雾化吸入佐治毛细支气管炎32例疗效观察. 儿科药学杂志, 2004, 10(6): 37-38.
16. 李红梅, 孙丽. 硫酸沙丁胺醇联合氨溴索雾化治疗小儿毛细支气管炎效果观察. 宁夏医科大学学报, 2012, 34(12): 1328-1329.
17. 郭丹萍. 硫酸沙丁胺醇溶液气泵吸入治疗小儿毛细支气管炎临床观察. 数理医药学杂志, 2008, 21(6): 680-681.
18. 刘广俊. 沙丁胺醇雾化吸入治疗毛细支气管炎的疗效观察. 右江医学, 2008, 36(4): 438-439.
19. 陈灿华, 丁娴, 高风, 等. 不同方法治疗毛细支气管炎的临床差异性分析. 医学理论与实践, 2008, 21(12): 1419-1421.
20. 李徽. 沙丁胺醇吸入疗法治疗婴幼儿毛细支气管炎后喘息56例疗效分析. 中国现代药物应用, 2010, 4(3): 140-141.
21. 韩世良. 沙丁胺醇治疗毛细支气管炎疗效观察. 现代医院, 2010, 10(z2): 52-53.
22. 韩应魁, 舒喘灵辅助治疗小儿毛细支气管炎128例疗效观察. 青海医药杂志, 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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