Evidence mapPaperPMID 41586743Full record

ArticleCritical care explorations2026

Inhaled L-Epinephrine As a Rescue Therapy in Critical Bronchiolitis.

Daniel Nigri, Meredith C Winter, Patrick A Ross, Ruiqi Huang, Justin C Hotz, Cristina Castro, Anoopindar Bhalla, Christopher J L Newth

Abstract read
In one paragraph

Article in Critical care explorations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Daniel NigriDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.ORCID 0009-0003-4141-9692
Meredith C WinterDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Patrick A RossDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Ruiqi HuangDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Justin C HotzDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Cristina CastroDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Anoopindar BhallaDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
Christopher J L NewthDepartment of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceViral bronchiolitis is the leading cause of nonelective admission to the PICU. Guidelines recommend management that focuses on supportive care. Evidence suggests that inhaled epinephrine may reduce lower airways resistance and work of breathing in critical bronchiolitis. It has been demonstrated at one institution that it is feasible to administer continuous inhaled epinephrine (CIE) via heated high-flow nasal cannula (HFNC).

objectivesTo describe the demographic and clinical characteristics of patients with bronchiolitis who received CIE and assess their physiologic response to treatment compared with patients who received conventional therapy. DESIGN, SETTING, AND

participantsWe performed a single-center retrospective cohort study of previously healthy children 0-2 years old admitted to the PICU with diagnosis of bronchiolitis from 2017 to 2023. MAIN OUTCOMES AND MEASURES: Physiologic response to treatment was assessed via analysis of vital signs and use of respiratory rate, oxygenation, heart rate (ROX-HR) index.

resultsOne hundred ninety-three patients were included in the study. Patients who received CIE were younger (median age, 4 vs. 7 mo old; p = 0.01) and smaller (7.0 vs. 8.4 kg; p = 0.06), presented with higher initial peak respiratory rates (70 vs. 50 beats/min; p < 0.0001), and had longer ICU stays (3.4 vs. 1.8 d; p < 0.001). Patients treated with CIE exhibited overall higher respiratory rates and lower ROX-HR indices, indicating more severe illness. Within the first 48 hours of treatment, patients receiving CIE demonstrated a more rapid improvement in both respiratory rate and ROX-HR index compared with those receiving conventional therapy. CONCLUSIONS AND RELEVANCE: In this cohort, CIE was used as novel therapy for younger, smaller patients with more severe bronchiolitis on presentation to the PICU. The physiologic changes suggest potential benefit of this therapy for patients who are not improving with conventional HFNC therapy.

Indexed as

BronchiolitisBronchodilator AgentsEpinephrineAdministration, InhalationFemaleHumansInfantInfant, NewbornIntensive Care Units, PediatricMaleRetrospective StudiesBronchodilator AgentsEpinephrinebronchiolitisepinephrinehigh-flow nasal cannula

Identifiers

PMID41586743
PMCPMC12834429

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.