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Response to first dose of inhaled albuterol in mechanically ventilated preterm infants

Thomas M Raffay1, Mandy Brasher2, Brooke C Place3

  • 1Pediatrics/Neonatology, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, OH, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 26, 2021
PubMed

Insights

Albuterol improved breathing in preterm infants by reducing airway resistance in 68% of cases. Hypoxemia also decreased, indicating a potential bedside measure for albuterol response in neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Bronchodilator responses in preterm infants are highly variable.
  • Identifying infants who benefit from bronchodilators is crucial for effective respiratory support.
  • Bedside measurements may offer a practical way to assess bronchodilator effectiveness.

Purpose of the Study:

  • To evaluate the impact of albuterol on respiratory mechanics and oxygenation in preterm infants.
  • To determine if bedside measurements can identify responders to albuterol.
  • To assess the consistency of albuterol response with repeated doses.

Main Methods:

  • Retrospective analysis of respiratory data (Resistance, Compliance, FiO2) and SpO2 in infants <30 weeks gestational age.
  • Included 33 mechanically ventilated infants receiving their first dose of albuterol.
  • Compared measurements before and after albuterol administration, with secondary analysis of subsequent doses.

Main Results:

  • Mean airway resistance significantly decreased post-albuterol (p=0.007), with 68% of infants classified as responders.
  • No significant changes were observed in compliance or FiO2.
  • Percent time in hypoxemia (SpO2 <85%) decreased significantly post-albuterol (p<0.02).
  • In responders, the magnitude of resistance change decreased with subsequent albuterol doses (p=0.01).

Conclusions:

  • Albuterol effectively reduced airway resistance in a majority of preterm infants, aligning with findings from formal pulmonary function testing.
  • While albuterol's effect on FiO2 was variable, decreased hypoxemia suggests its utility in assessing bronchodilator response.
  • Bedside monitoring of hypoxemia may serve as a valuable tool for evaluating albuterol effectiveness in this population.
Abstract

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