Computerized acoustic assessment of treatment efficacy of nebulized epinephrine and albuterol in RSV bronchiolitis

Computerized lung sounds analysis with quantification of wheezing and crackles and a clinical score were used during a double blind, randomized, controlled nebulized treatment pilot study. Infants were randomized to receive a single dose of 1 mgr nebulized l-epinephrine or 2.5 mgr nebulized albuterol. Computerized quantification of wheezing and crackles (PulmoTrack？) and a clinical score were performed prior to, 10 minutes post and 30 minutes post treatment. Results were analyzed with Student's t-test for independent samples, Mann-Whitney U test and Wilcoxon test.15 children received albuterol, 12 received epinephrine. The groups were identical at baseline. Satisfactory lung sounds recording and analysis was achieved in all subjects. There was no significant change in objective quantification of wheezes and crackles or in the total clinical scores either within the groups or between the groups. There was also no difference in oxygen saturation and respiratory distress.Computerized lung sound analysis is feasible in young infants with RSV bronchiolitis and provides a non-invasive, quantitative measure of wheezing and crackles in these infants.Trial registration number: ClinicalTrials.gov NCT00361452Bronchiolitis is the most common cause of hospitalization for respiratory infection in infants under one year of age. Respiratory syncytial virus (RSV) is the most common etiology of acute bronchiolitis in infants. About 1–2% of infants with bronchiolitis need to be hospitalized and approximately 8% of these children require intensive care. Of high risk patients, such as those with bronchopulmonary dysplasia or congenital heart disease, about 30% require intensive care [1-3].Treatment for most infants with bronchiolitis is usually supportive, including oxygen, hydration and antipyretics. The use of bronchodilator therapy remains controversial [4,5], since the main tool used to measure response (clinical score) is subjective and inaccurate. Thus different studies showed dif