Albuterol saline
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Efficacy and Safety of Albuterol and Saline in Various Clinical Settings
Albuterol and Saline in Hyperkalemia Treatment
Nebulized Albuterol for Hyperkalemia in Hemodialysis Patients
Nebulized albuterol has been shown to be effective in reducing plasma potassium levels in patients undergoing chronic hemodialysis. In a study involving ten patients, albuterol doses of 10 mg and 20 mg resulted in significant decreases in plasma potassium concentrations, with reductions of 0.62 mmol/L and 0.98 mmol/L, respectively. These effects were observed within 30 minutes and sustained for at least 2 hours. Importantly, nebulized saline did not produce significant changes in potassium levels, and albuterol treatment did not cause adverse cardiovascular effects, making it a viable option for acute hyperkalemia management in this patient population1.
Albuterol in Premature Neonates with Hyperkalemia
In premature neonates with hyperkalemia, inhaled albuterol was also found to be effective. A study demonstrated that albuterol significantly reduced serum potassium levels within the first 4 hours of administration, whereas saline did not produce significant changes. This suggests that albuterol can be a useful intervention for rapidly lowering potassium levels in this vulnerable group4.
Albuterol and Saline in Bronchiolitis Management
Efficacy of Albuterol in Bronchiolitis
Several studies have evaluated the efficacy of albuterol in treating bronchiolitis in infants. One study found that nebulized albuterol did not significantly improve clinical outcomes compared to saline in infants with bronchiolitis, as measured by oxygen saturation, respiratory rate, and clinical scores2. Another study confirmed these findings, showing no significant differences in recovery or severity of illness between albuterol and saline treatments in hospitalized infants with moderate bronchiolitis3.
Tidal Breathing Flow-Volume Loops in Bronchiolitis
A study assessing the effect of nebulized albuterol on tidal breathing flow-volume loops in infants with bronchiolitis found no significant improvements in key respiratory parameters compared to saline. Although some measures like TEF10 and 25/PT showed slight improvements with albuterol, the overall clinical benefit was minimal6.
Albuterol in Emergency Department for Wheezing Infants
In contrast, a study conducted in an emergency department setting found that nebulized albuterol significantly improved wheeze scores and total clinical scores in wheezing infants compared to saline. This suggests that albuterol may be beneficial in acute settings for immediate symptom relief7.
Albuterol and Saline in Asthma Management
Combination Therapy in Asthma Exacerbations
In children with acute asthma exacerbations, combining nebulized magnesium sulfate with albuterol provided short-term benefits over albuterol with saline, as evidenced by significant improvements in FEV1 at 10 and 20 minutes post-treatment8. However, another study comparing albuterol alone to a combination of albuterol and ipratropium bromide found no significant additive benefit in terms of FEV1 improvement or clinical outcomes9.
Conclusion
The efficacy of albuterol varies depending on the clinical context. It is effective in reducing hyperkalemia in both hemodialysis patients and premature neonates. However, its benefits in bronchiolitis are less clear, with some studies showing minimal to no improvement over saline. In acute asthma exacerbations, albuterol combined with magnesium sulfate may offer additional benefits, but the combination with ipratropium bromide does not seem to provide significant advantages. These findings highlight the importance of context-specific evaluation when considering albuterol and saline treatments.
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Most relevant research papers on this topic
Nebulized albuterol for acute hyperkalemia in patients on hemodialysis.
Nebulized albuterol therapy effectively decreases plasma potassium levels in patients on hemodialysis without causing adverse cardiovascular effects.
RCT
Highly CitedEfficacy of albuterol in the management of bronchiolitis.
Albuterol is as effective as oral placebo in managing bronchiolitis in infants, with past studies not considering change in infant state and using a truly inactive placebo group.
RCTHighly CitedThe Use of Albuterol in Hospitalized Infants With Bronchiolitis
Nebulized albuterol therapy does not appear to enhance recovery or attenuate severity of illness in infants hospitalized with acute, moderate bronchiolitis, as evidenced by improvement in oxygen saturation, time to meet standardized discharge criteria, or length of hospital stay.
RCTHighly CitedEfficacy of albuterol inhalation in treatment of hyperkalemia in premature neonates.
Albuterol inhalation may be useful in rapidly lowering serum potassium levels in premature neonates.
RCTTolerability and Efficacy of Two Doses of Aerosolized Albuterol in Ventilated Infants with BPD
Aerosolized albuterol at 1.25mg and 2.5mg doses did not affect expiratory flow at 75% of exhalation in infants with severe bronchopulmonary dysplasia receiving invasive ventilation, but 2.5mg dose showed greater inspiratory pressure improvement.
RCTTidal breathing flow-volume loops in bronchiolitis in infancy: the effect of albuterol [ISRCTN47364493]
Nebulized albuterol in infants with mild respiratory syncytial virus bronchiolitis did not improve VPTEF/VE and tPTEF/tE but decreased TEF10 and 25/PT.
RCTThe use of nebulized albuterol in wheezing infants.
Nebulized albuterol significantly improves wheeze and total scores in infants aged 0 to 24 months compared to placebo, with no significant differences in heart rate or respiratory rate.
RCTComparison of nebulized magnesium sulfate plus albuterol to nebulized albuterol plus saline in children with acute exacerbations of mild to moderate asthma.
Nebulized magnesium sulfate and albuterol provide short-term benefits in children with acute exacerbations of mild to moderate asthma compared to albuterol and saline alone.
RCTA comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma.
Nebulized ipratropium bromide and albuterol showed no significant additive benefit in treating acute asthma in inner city patients.
RCT
Large Human TrialHighly CitedNebulized albuterol in acute bronchiolitis.
Nebulized albuterol is a safe and effective treatment for infants with bronchiolitis, improving respiratory rate and muscle score without causing side effects.
RCTHighly Cited