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The role of hypodermic injection with low dose of adrenaline in emergency treatment of severe asthma

Weiguo Gong, Jiange Jiang, Houzhen Fan

Objective: To explore the effect of subcutaneous injection of low dose adrenaline on emergency treatment of severe asthma.

Methods: A total of 124 cases with severe asthma treated in our hospital from January 2016 to April 2017 were selected as the subjects and randomly divided into observation group and control group according to different emergency treatment methods, 62 cases in each group. The patients in the control group were given conventional emergency salvage after admission while those the observation group were injected low dose adrenaline with the total dose no more than 1mg. The changes and improvements in symptoms and signs such as blood oxygen saturation, heart rate and respiration were recorded in the two groups before, during and after treatment. And airway function as well as serum levels of inflammatory factors of IL- 6, IL-8, IL-17 and TNF-a were compared between the two groups.

Results: Before treatment, there was no significant difference in the scores of RR, HR, SaO₂ between the two groups (P>0.05), while at 10 and 30 minutes after treatment, compared with the control group, the RR and HR scores were significantly lower (P<0.001) and SaO₂ significantly higher (P<0.001) in the observation group. During the treatment, the total effective rate in the two groups was on the rise, while at 30 minutes after treatment, the total effective rate was significantly higher in the observation group than in the control group (Z=35.168, P<0.001). Before treatment, no significant difference was found between the two groups in TEF 25%, TEF 50%, TEF 75% and FEV1/FV (P>0.05), while after treatment, the levels of TEF 25%, TEF 50%, TEF 75% and FEV1/FVC were increased in the two groups, more significantly in the observation group than in the control group, and the difference was statistically significant (P<0.05). Before treatment, there was no significant difference between the two groups in the levels of IL-6, IL-8, IL-17 and TNF-a (P>0.05), while after treatment, the levels of IL-6, IL-8, IL-17 and TNF-a were decreased in the two groups, more significantly in the observation group than in the control group, and the differences were statistically significant (P<0.05).

Conclusion: Compared with conventional methods in emergency severe asthma, the treatment with small dose of epinephrine is of rapid onset and has better therapeutic effects of suppressing cough, relieving spasm, relaxing smooth muscle as well as reducing capillary permeability, besides, the method, with few adverse reactions, good tolerance as well as safety enables to improve SaO₂ as well as airway function and lower serum inflammatory factors in patients, thus worthy of clinical application and spreading.