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Epinefrina inhalada con L como terapia de rescate en bronquiolitis crítica
Daniel Nigri1,2,3, Meredith C Winter1,4, Patrick A Ross1,4
1Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Critical care explorations
|January 26, 2026
Resumen
La epinefrina inhalada continua (EIC) puede beneficiar a los lactantes con bronquiolitis grave, mostrando una mejora más rápida del estado respiratorio en comparación con la terapia convencional. Este enfoque novedoso justifica una mayor investigación para casos pediátricos críticos.
Área de la Ciencia:
- Medicina de cuidados intensivos pediátricos
- Neumología
- Farmacología
Sus antecedentes:
- La bronquiolitis viral es la principal causa de ingresos en la unidad de cuidados intensivos pediátricos (UCIP).
- Las directrices actuales enfatizan el cuidado de apoyo para la bronquiolitis.
- La epinefrina inhalada continua (EIC) a través de una cánula nasal de alto flujo calentada (CNFC) es una opción terapéutica potencial.
Objetivo del estudio:
- Caracterizar a los pacientes con bronquiolitis que recibieron EIC.
- Comparar la respuesta fisiológica a la EIC frente a la terapia convencional.
- Evaluar la EIC como un tratamiento novedoso para la bronquiolitis grave.
Principales métodos:
- Estudio de cohorte retrospectivo unicéntrico.
- Inclusión de niños previamente sanos de 0 a 2 años ingresados en la UCIP con bronquiolitis (2017-2023).
- Evaluación de la respuesta fisiológica utilizando signos vitales y el índice ROX-HR.
Principales resultados:
- Los pacientes que recibieron EIC eran más jóvenes, más pequeños y presentaban tasas de respiración iniciales más altas, lo que indica una enfermedad más grave.
- El grupo de EIC mostró tasas de respiración más altas y índices ROX-HR más bajos inicialmente.
- Los pacientes tratados con EIC demostraron una mejora más rápida en la frecuencia respiratoria y el índice ROX-HR en 48 horas.
Conclusiones:
- La EIC se utilizó en pacientes más jóvenes y pequeños con bronquiolitis más grave.
- Las mejoras fisiológicas sugieren que la EIC puede beneficiar a los pacientes no respondedores.
- Este estudio destaca la EIC como una posible terapia novedosa para la bronquiolitis crítica.
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