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Effects of inhaled formoterol compared with salbutamol in ventilated preterm infants
E Rieger-Fackeldey1, D Reinhardt, A Schulze
1Dr v. Hauner's Children's Hospital and Division of Neonatology, Department of Obstetrics and Gynecology, Klinikum Grosshadern, Ludwig Maximilian University of Munich, Marchioninistrasse 15, D-81377 Munich, Germany. esther.fackeldey@med.uni-muenchen.de
Background:
Short-acting beta(2)-agonists have shown beneficial effects in preterm infants, but data on long acting beta(2)-agonists are still lacking.
Objectives:
To compare the effects of inhaled formoterol with salbutamol in preterm infants.
Methods:
Randomized, double-blind, crossover design of salbutamol (100 microg every 6 h) or formoterol (12 microg every 12 h) delivered by metered dose inhaler on two consecutive days to very low birth weight infants on assisted mechanical ventilation (n=12; gestational age 25.7+/-2 weeks; birth weight 720+/-254 g; postnatal age 25+/-9 days; mean+/-SD). Treatment with the second drug was administered until day 7 in eight infants. Outcome variables were minute volume MV, respiratory mechanics, heart rate HR, blood pressure, serum potassium and blood glucose levels.
Results:
Mean MV increased by maximal 26% (salbutamol) and by 22% (formoterol) differing from baseline values until 6 and 8 h through increased mean tidal volume (Vt) in both groups (max. 14%). Mean static compliance (Crs) increased by 26% (salbutamol) and by 32% (formoterol) until 60 min post-administration. There was no tachyphylaxis.
Conclusion:
Inhaled salbutamol and formoterol equally increase MV, Vt, Crs and HR in mechanically ventilated infants with a longer lasting systemic effect of formoterol.
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