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

Thomas M. Raffay; Mandy Brasher; Brooke C. Place; Abhijit Patwardhan; Peter J. Giannone; Henrietta Bada; Philip M. Westgate; Elie G. Abu Jawdeh

doi:10.1038/s41372-021-01071-0

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

Thomas M. Raffay, Mandy Brasher, Brooke C. Place, Abhijit Patwardhan, Peter J. Giannone, Henrietta Bada, Philip M. Westgate, Elie G. Abu Jawdeh

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background: Bronchodilator responses among preterm infants are heterogeneous. Bedside measurements may identify responders. Study design: Respiratory measurements (Resistance, Compliance, FiO₂) and pulse oximetry (SpO₂) patterns were downloaded from infants <30 weeks gestational age during the first 2 months of life. Mechanically ventilated infants who received albuterol were included (n = 33). Measurements were compared before and after first albuterol. Secondary analyses assessed subsequent doses. Results: Median gestation and birthweight were 25 3/7 weeks and 730 g, respectively. Mean Resistance decreased post-albuterol (p = 0.007). Sixty-eight percent of infants were responders based on decreased Resistance. Compliance and FiO₂ did not significantly differ. Percent time in hypoxemia (SpO₂< 85%) decreased post albuterol (p < 0.02). In responders, Resistance changes diminished with subsequent administration (all p = 0.01). Conclusions: Ventilator resistance decreased in two-thirds of preterm infants, consistent with studies that utilized formal pulmonary function testing. Albuterol had a variable effect on delivered FiO₂; however, hypoxemia may be useful in evaluating albuterol response.

Original language	English
Pages (from-to)	1704-1710
Number of pages	7
Journal	Journal of Perinatology
Volume	41
Issue number	7
DOIs	https://doi.org/10.1038/s41372-021-01071-0
State	Published - Jul 2021

Bibliographical note

Funding Information:
Funding: The study was funded in part by: (1) The Gerber Foundation (EGA, PI) (2) Kentucky Children’s Hospital Children’s Miracle Network Research Fund (EGA, PI), (3) University of Kentucky’s National Center for Advancing Translational Sciences, UL1RR033173. TMR is supported by NIH K08HL133459-04 grant.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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10.1038/s41372-021-01071-0

Cite this

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title = "Response to first dose of inhaled albuterol in mechanically ventilated preterm infants",

abstract = "Background: Bronchodilator responses among preterm infants are heterogeneous. Bedside measurements may identify responders. Study design: Respiratory measurements (Resistance, Compliance, FiO2) and pulse oximetry (SpO2) patterns were downloaded from infants <30 weeks gestational age during the first 2 months of life. Mechanically ventilated infants who received albuterol were included (n = 33). Measurements were compared before and after first albuterol. Secondary analyses assessed subsequent doses. Results: Median gestation and birthweight were 25 3/7 weeks and 730 g, respectively. Mean Resistance decreased post-albuterol (p = 0.007). Sixty-eight percent of infants were responders based on decreased Resistance. Compliance and FiO2 did not significantly differ. Percent time in hypoxemia (SpO2< 85%) decreased post albuterol (p < 0.02). In responders, Resistance changes diminished with subsequent administration (all p = 0.01). Conclusions: Ventilator resistance decreased in two-thirds of preterm infants, consistent with studies that utilized formal pulmonary function testing. Albuterol had a variable effect on delivered FiO2; however, hypoxemia may be useful in evaluating albuterol response.",

author = "Raffay, {Thomas M.} and Mandy Brasher and Place, {Brooke C.} and Abhijit Patwardhan and Giannone, {Peter J.} and Henrietta Bada and Westgate, {Philip M.} and {Abu Jawdeh}, {Elie G.}",

note = "Funding Information: Funding: The study was funded in part by: (1) The Gerber Foundation (EGA, PI) (2) Kentucky Children{\textquoteright}s Hospital Children{\textquoteright}s Miracle Network Research Fund (EGA, PI), (3) University of Kentucky{\textquoteright}s National Center for Advancing Translational Sciences, UL1RR033173. TMR is supported by NIH K08HL133459-04 grant. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.",

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AU - Patwardhan, Abhijit

AU - Giannone, Peter J.

AU - Bada, Henrietta

AU - Westgate, Philip M.

AU - Abu Jawdeh, Elie G.

N1 - Funding Information: Funding: The study was funded in part by: (1) The Gerber Foundation (EGA, PI) (2) Kentucky Children’s Hospital Children’s Miracle Network Research Fund (EGA, PI), (3) University of Kentucky’s National Center for Advancing Translational Sciences, UL1RR033173. TMR is supported by NIH K08HL133459-04 grant. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.

PY - 2021/7

Y1 - 2021/7

N2 - Background: Bronchodilator responses among preterm infants are heterogeneous. Bedside measurements may identify responders. Study design: Respiratory measurements (Resistance, Compliance, FiO2) and pulse oximetry (SpO2) patterns were downloaded from infants <30 weeks gestational age during the first 2 months of life. Mechanically ventilated infants who received albuterol were included (n = 33). Measurements were compared before and after first albuterol. Secondary analyses assessed subsequent doses. Results: Median gestation and birthweight were 25 3/7 weeks and 730 g, respectively. Mean Resistance decreased post-albuterol (p = 0.007). Sixty-eight percent of infants were responders based on decreased Resistance. Compliance and FiO2 did not significantly differ. Percent time in hypoxemia (SpO2< 85%) decreased post albuterol (p < 0.02). In responders, Resistance changes diminished with subsequent administration (all p = 0.01). Conclusions: Ventilator resistance decreased in two-thirds of preterm infants, consistent with studies that utilized formal pulmonary function testing. Albuterol had a variable effect on delivered FiO2; however, hypoxemia may be useful in evaluating albuterol response.

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

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