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

3 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

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

Funding

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.

Funders	Funder number
EGA
Kentucky Children’s Hospital Children’s Miracle Network Research Fund
University of Kentucky’s National Center for Advancing Translational Sciences	UL1RR033173
National Institutes of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)	K08HL133459
Gerber Foundation

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

Access to Document

10.1038/s41372-021-01071-0

Cite this

@article{8e6cc3eca2fe4fe6b68a411c594aad62,

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 = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Nature America, Inc.",

year = "2021",

month = jul,

doi = "10.1038/s41372-021-01071-0",

language = "English",

volume = "41",

pages = "1704--1710",

number = "7",

}

TY - JOUR

T1 - Response to first dose of inhaled albuterol in mechanically ventilated preterm infants

AU - Raffay, Thomas M.

AU - Brasher, Mandy

AU - Place, Brooke C.

AU - Patwardhan, Abhijit

AU - Giannone, Peter J.

AU - Bada, Henrietta

AU - Westgate, Philip M.

AU - Abu Jawdeh, Elie G.

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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85106417144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85106417144&partnerID=8YFLogxK

U2 - 10.1038/s41372-021-01071-0

DO - 10.1038/s41372-021-01071-0

M3 - Article

C2 - 34035457

AN - SCOPUS:85106417144

SN - 0743-8346

VL - 41

SP - 1704

EP - 1710

JO - Journal of Perinatology

JF - Journal of Perinatology

IS - 7

ER -

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

Abstract

Bibliographical note

Funding

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this