It too is my impression that some children with 'bronchiolitis' respond to albuterol, those
children are also usually excluded from in-hospital trials of albuterol vs vaponehprine/etc b/c
they get sent home!  IT is so simple to try - giving some albuterol treatments, and if the
children respond then home they go with an albuterol MDI, mask spacer, and teaching by RT.
Usually if they respond to albuterol and if there's any family history of RAD/asthma then I give
them steroids as well.  I think the real point is that even with RSV infection its impossible to
sort out those kids with underlying RAD component from those children with purely epithelial
damage and clogging of the bronchioles from RSV.  Seeing if they respond to albuterol is fast,
easy, and allows dishcarge of responders.

Virgil Davis

Chris Ritchey wrote:

> I have no literature to prove this statement.
> This is a purely anecdotal comment.
> I have seen kids wheezing with and without RSV respond to albuterol at
> variable degrees.
> It is not clear to me that all kids with bronchiolitis do not respond to
> albuterol.
> I routinely inform parents that it is more likely that their child may be
> asthmatic since they are responding to albuterol.
> (e.g. first time wheezer and RSV positive)
> How does one separate out the true asthmatics and the true bronchiolitics?
> Now that would be a good study!
> Chris Ritchey
> 1301 St. John St.
> Lafayette, LA 70506
> [log in to unmask]
>  -----Original Message-----
> From:   Martin Herman [mailto:[log in to unmask]]
> Sent:   Friday, March 24, 2000 2:43 AM
> To:     Chris Ritchey; [log in to unmask]
> Subject:        Re: RSV management survey
> Chris, This raises up agood point re: albuterol and bronchiolitis.
> In the past there were numerous articles that clearly failed to show any
> salient effect of albuterol ( salbutamol) on bronchiloitis. What is your
> evidence?
> As an aside I have observed that , if a wheezing child has a family history
> for reactive airway disease ie Asthma, then their chance of responding to
> albuterol is good. Perhaps the cases of bronchiolitis that you feel respond
> to albuterol were actually bronchospam/asthmatic and not actually
> bronchiolitis ..
> Looknig forward to seeing some articles here to support or refute my
> supposition that albuterol in true bronchiloitis is futile.
> Martin Herman,
> For more information, send mail to [log in to unmask] with the message: info PED-EM-L
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