A Randomized, Controlled Trial of Nasal Phenylephrine in Infants Hospitalized for Bronchiolitis

Objective To examine the hypothesis that pharmacologic treatment of nasal obstruction, specifically alpha-adrenergic nose drops, will decrease objective signs of respiratory distress in infants with bronchiolitis. Study design Forty-one infants aged 3 weeks to 1.2 months hospitalized for viral bronchiolitis were enrolled in this double-blinded, placebo-con trolled trial of topical 0.5% phenylephrine drops. The primary outcome measure was change in oxygen saturation. Secondary outcomes were changes in respiratory scores and vital signs. Results There were no statistical differences in any of the outcome measures between groups. No adverse events were observed. Overall, participants showed an average 1.6 percentage point increase in their oxygen saturations (P = .002) and a 0.5-point improvement in respiratory score (P = .003) over the 30 minutes of the study. Conclusions Topical nasal phenylephrine did not produce significant short-term improvements in clinical status in infants hospitalized for acute bronchiolitis. (J Pediatr 2008;153:795-8)