Safety of Nebulized Epinephrine in Smoke Inhalation Injury

Guillermo Foncerrada, Francisco Lima, Robert P. Clayton, Ronald P. Mlcak, Perenlei Enkhbaatar, David Herndon, Oscar Suman

Research output: Contribution to journalArticle

5 Citations (Scopus)

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 more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care 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.

Original languageEnglish (US)
JournalJournal of Burn Care and Research
DOIs
StateAccepted/In press - May 16 2017

Fingerprint

Smoke Inhalation Injury
Epinephrine
Safety
Mechanical Ventilators
Standard of Care
Racepinephrine
Burn Units
Albuterol
Acetylcysteine
Bronchoscopy
Chest Pain
Burns
Heparin
Cardiac Arrhythmias
Arterial Pressure
Hemodynamics
Pediatrics
Pressure

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Rehabilitation

Cite this

Safety of Nebulized Epinephrine in Smoke Inhalation Injury. / Foncerrada, Guillermo; Lima, Francisco; Clayton, Robert P.; Mlcak, Ronald P.; Enkhbaatar, Perenlei; Herndon, David; Suman, Oscar.

In: Journal of Burn Care and Research, 16.05.2017.

Research output: Contribution to journalArticle

Foncerrada, Guillermo ; Lima, Francisco ; Clayton, Robert P. ; Mlcak, Ronald P. ; Enkhbaatar, Perenlei ; Herndon, David ; Suman, Oscar. / Safety of Nebulized Epinephrine in Smoke Inhalation Injury. In: Journal of Burn Care and Research. 2017.
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