She did not require racemic epinephrine
, which was ordered as needed.
This may be accomplished by humidified oxygen therapy, nebulized racemic epinephrine
, noninvasive positive pressure ventilation, or reintubation .
In a retrospective study of 50 children with croup who were given aerosolized racemic epinephrine
and observed in the ED for 2 hours after treatment, 58% received steroids
Human blood pressure and pulse rate response to racemic epinephrine
The AHRQ (2003) recommends additional, large, well-designed studies be conducted before evidence-based recommendations can be made for the use of albuterol, racemic epinephrine
, or corticosteroids in the management of RSV infections.
The positive response rate to inhaled racemic epinephrine
was significantly higher at 54,3% among premature infants, compared with 28% among full-term infants (P = .003).
She was noted to have significant subcostal retractions for which she was given vaporized racemic epinephrine
and dexamethasone intravenously once.
The only mention I could find concerning aerosol therapy of the ventilated neonate was in the chapter on pharmacological adjuncts in a section entitled "Bronchodilators and Mucolytic Agents." The only inhalation drugs that are mentioned in this section are albuterol, acetylcysteine cromolyn sodium and racemic epinephrine
. This section begins with a statement that claims that the misconception that premature infants were thought to have too little bronchiolar smooth muscles to experience bronchospasm has been disproved.
If the stridor is severe enough, racemic epinephrine
is given to the child.
-- Heliox may have a beneficial effect when used to deliver racemic epinephrine
to young children with bronchiolltis, suggest the results of a randomized controlled trial.
In the hospital, the patient was treated with alternating albuterol and racemic epinephrine
aerosols in addition to a systemic steroid, but relief was minimal.
Patients receiving racemic epinephrine
at the first visit were more likely to return, regardless of the route of dexamethasone administration.