Comparison of the effects on lung function of two methods of bronchodilator administration

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B Yuksel1, A Greenough

  • 1Department of Child Health, King's College Hospital, London, U.K.

Respiratory Medicine
|March 1, 1994
PubMed

Insights

Administering salbutamol via a metered dose inhaler (MDI) avoids early lung function decline in premature infants compared to nebulizers. Both MDI and nebulizer provide similar long-term bronchodilation, making MDI the preferred delivery method.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Neonatology

Background:

  • Premature infants often experience respiratory issues.
  • Bronchodilator delivery methods (MDI vs. nebulizer) impact lung function.
  • Paradoxical deterioration in lung function is a concern.

Purpose of the Study:

  • To compare the efficacy of metered dose inhaler (MDI) versus nebulizer for salbutamol delivery in premature infants.
  • To determine if MDI administration prevents early paradoxical airway resistance increase.
  • To assess if both methods provide equivalent late bronchodilation.

Main Methods:

  • Fifteen premature infants (median gestational age 27 weeks) were studied.
  • Lung function (airway resistance) was measured using plethysmography.
  • Salbutamol was administered via MDI and nebulizer in random order, with measurements taken at baseline, 5, and 15 minutes.

Main Results:

  • Nebulized salbutamol caused a 16% increase in airway resistance at 5 minutes, while MDI salbutamol showed a 3% improvement (P < 0.03).
  • At 15 minutes, both MDI and nebulizer groups showed similar bronchodilation (15% and 14% improvement, respectively).
  • MDI administration avoided the early paradoxical deterioration in lung function.

Conclusions:

  • Metered dose inhaler (MDI) administration of salbutamol is preferred for premature infants due to avoidance of early lung function deterioration.
  • Both MDI and nebulizer delivery achieve comparable bronchodilation at 15 minutes.
  • MDI use may be a safer and equally effective method for bronchodilator delivery in this population.

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