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      Safety of Nebulized Epinephrine in Smoke Inhalation Injury

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          Abstract

          This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD] 12 ± 4 years) with burns covering over 30% of the total body surface area (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (SOC; n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive SOC plus nebulized epinephrine (n = 8). Primary endpoints were death, chest pain, and adverse changes in cardiopulmonary hemodynamics (arrhythmia, arterial blood pressure, electrocardiographic [ST segment] changes, and peak inspiratory pressure). Additional endpoints included total days on ventilator, pulmonary function, and physiological cardiopulmonary measurements at ICU discharge. No adverse events were observed during or after the nebulization of epinephrine, and no deaths were reported that were attributable to the administration of nebulized epinephrine. The groups did not significantly differ with regard to age, sex, burn size, days on ventilator, pulmonary function, or cardiopulmonary fitness. Results of this pilot trial indicate epinephrine to be safe when administered to pediatric burn patients with smoke inhalation injury. Current data warrant future efficacy studies with a greater number of patients.

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          Author and article information

          Journal
          101262774
          32828
          J Burn Care Res
          J Burn Care Res
          Journal of burn care & research : official publication of the American Burn Association
          1559-047X
          1559-0488
          13 April 2017
          Nov-Dec 2017
          01 November 2018
          : 38
          : 6
          : 396-402
          Affiliations
          [a ]Department of Surgery, University of Texas Medical Branch Galveston, Galveston, Texas
          [b ]Shriners Hospitals for Children, Galveston, Texas
          Author notes
          Address correspondence to: Oscar E. Suman, PhD, Shriners Hospitals for Children, 815 Market Street, Galveston, Texas 77550, USA; Tel: +1 409 770 6557, Fax: +1 409 770 6919. oesuman@ 123456utmb.edu
          Article
          PMC5662490 PMC5662490 5662490 nihpa868110
          10.1097/BCR.0000000000000575
          5662490
          28570317
          00dc4ae8-80eb-48d9-bf40-113914e0136a
          History
          Categories
          Article

          nebulized epinephrine,Burns,smoke inhalation injury
          nebulized epinephrine, Burns, smoke inhalation injury

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