EYLEM ULAŞ SAZ, Levent MİDYAT, Muhterem DUYU, Yeliz OZANANAR, Bülent KARAPINAR, MUSTAFA ÖZÇETİN

Akut bronşiyolitli olguların acil servisteki tedavilerinde nebulizatör veya aracı tüp kullanımının etkinliğinin karşılaştırılması

Akut bronşiyolit, 2 yaş altı bebeklerde alt solunum yolu enfeksiyonlarının en sık nedenlerinden biridir. Acil servislerde inhale beta 2 agonistlerin nebulizasyon uygulamaları çok zaman almaktadır. Bu çalışmadaki amaç, uygun doz salbutamolün nebulizatörle veya aracı tüp (aerochamber) ile verilmesinin sonuçlarının karşılaştınlmasıdır. Ege Üniversitesi Tıp Fakültesi Çocuk Acil Servisi 'ne Ocak - Şubat 2009 tarihleri arasında gündüz saatlerinde öksürük ve/veya hırıltılı solunum nedeniyle başvurup akut bronşiyolit tanısı alan 1-24 ay arasındaki 35 olgu çalışmaya alındı. Randomize olarak olgular nebulizasyon grubu (Grup 1) ve aracı tüp grubu (Grup 2) olarak iki gruba ayrıldı. Grup 1 'de tedavi öncesi ortalama solunum skoru 9.39±6, tedavi sonrası ortalama düşüş 1.5±1.1; Grup 2 'de ise bu değerler 10.2±8.4, ortalama düşüş 1.1 ±0.9 olarak bulundu (p>0.05). Her iki grupta da inhalasyon etkinliğinin benzer olduğu ve olgulardan sadece 1 'er tanesinin servise yatırıldığı görüldü. Akut bronşiyolitin acil servislerdeki yönetiminde aracı tüp ile salbutamol uygulaması hem zamandan kazanmak için daha iyi, hem de etkinlik açısından nebulize uygulama ile benzer sonuçlar doğurması açısından tercih edilebilir bir yöntemdir.

Anahtar Kelimeler:

Bronşiyolit, Akut hastalık, Nebülizerler ve vaporizerler, İnhalasyon aracı, Çocuk

Efficacy comparison of nebulizator or spacer usage for acute bronchiolitis treatment in emergency department

Acute bronchiolitis is one of the most common causes of lower respiratory tract infections in children. Nebulization of inhaled beta-2 agonists in emergency departments is time-consuming. In this study, effects of inhalation of appropriate dose of inhaled salbutamol by nebulization or by spacer are compared. Thirty-five patients between ages of 1-24 months old who were admitted in daytime to Ege University Faculty of Medicine Child Emergency Department for cough and/or wheezing and diagnosed as acute bronchiolitis were enrolled to the study. Patients were randomized into two groups; nebulization group (Group 1) and spacer group (Group 2). In Group 1, mean respiratory score before the treatment and mean decrease after the, treatment were 9.39±6 and 1.5±1.1; in Group 2, the scores were 10.2±8.4 and l.l±0.9, respectively (p>0.05). Efficacy of inhalation was about the same in both groups and only one of the patients in each group was hospitalized due to acute bronchiolitis. In management of acute bronchiolitis in emergency departments, usage of spacer for administration of inhaled salbutamol is apreferrable method for two reaseons; it is better for time saving, and has the same efficacy with nebulization.

Keywords:

Bronchiolitis, Acute Disease, Nebulizers and Vaporizers, Inhalation Spacers, Child,

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