Another Look at Nebulized Saline and Racemic Epinephrine for Treatment of Bronchiolitis

Current guidelines do not recommend the use of bronchodilators for bronchiolitis, even though racemic epinephrine should theoretically reduce airway edema (JW Pediatr Adolesc Med 2007 Jan 10). In this multicenter study, researchers in Norway randomized 404 hospitalized infants (mean age, 4 months) with moderate-to-severe bronchiolitis to receive nebulized racemic epinephrine or normal saline either on a fixed schedule (up to every 2 hours) or on demand.

In robust linear regression analysis, length of stay was similar in the racemic-epinephrine and normal-saline groups (64 vs. 68 hours). However, in both groups, mean length of stay was significantly shorter for infants who received the nebulized solution on demand than for infants on a fixed-…