Albuterol and Bronchopulmonary Dysplasia

November 30, 2008

Albuterol relaxes the smooth muscle in the lungs and dilates airways to improve breathing. It is used in the treatment of asthma, chronic bronchitis, and emphysema. The inhaler enables the drug to reach deep into the lungs for maximum benefit.

Bronchodilators are frequently used as part of the therapeutic regimen of ventilated preterm infants. There is conflicting evidence about the efficacy of bronchodilators such as albuterol. However, doctors usually administer the bronchodilators to children on a trial basis to assess response, which should be evaluated every 5 to 10 minutes. If improvement occurs, aerosol treatment may be continued. A study at Albert Einstein Medical Center identified the most efficient, cost-effective nebulizer device for delivery of albuterol aerosol as a bronchodilator in ventilated preterm infants. Fifty-three premature infants being ventilated for respiratory distress syndrome (RDS) were studied. Twenty-four received standard doses of albuterol aerosol via jet nebulizer and 29 via a metered dose inhaler. Heart rate, respiratory rate, oxygen saturation, lung compliance, and airway resistance were monitored prior and 15 minutes after albuterol delivery. There were significant changes in health between pre- and postnebulizer treatment. Both groups significantly improved lung function with a 13-24% reduction in airway resistance and three to seven percent increase in lung compliance. Oxygen saturations also increased. These findings suggest that both MDI-spacer and jet nebulizer are equally effective in delivering the albuterol aerosol to the lower respiratory tract.

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