Dose-related bronchodilator response to aerosolized salbutamol (albuterol) in ventilator-dependent premature infants

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We used a placebo-controlled standardized protocol to define the dose-response relationship to the β-adrenergic bronchodilator salbutamol (albuterol) in 10 ventilator-dependent premature infants at a postnatal age of 13.3±4.9 days. Passive respiratory system resistance and compliance were measured at baseline and 10 minutes after administration of salbutamol via a metered-dose inhaler and spacer device. Salbutamol caused a significant dose-related response with a 33% mean decrease in respiratory system resistance (p<0.05) and a 67% mean increase in respiratory system compliance (p<0.001). In seven and six patients, respectively, 100 μg of salbutamol caused significant improvement in resistance and compliance; 200 μg was required in the remainder, but one patient had no improvement in compliance. Oxygen saturation increased linearly with the increase in compliance. In 7 of the 10 infants, the duration of action of 200 μg of salbutamol on the following day was 3 hours. We conclude that bronchodilator treatment may be useful in the management of ventilator-dependent neonates with respiratory distress syndrome.

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