Bronchodilator response to albuterol nebulized with hypertonic saline in asthmatic children

Abstract

Introduction: Asthma is distinguished by bronchial obstruction reversible by bronchodilators. The first-line treatment for asthmatic exacerbations is the use of inhaled beta-agonists, by pressurized metered-dose inhalers or nebulized with normal saline solution (NSS). There are no reports of nebulized beta agonists' efficacy in asthmatic children when administered with hypertonic saline solution (HSS).Objective: To evaluate bronchodilator responses (BDR) to albuterol nebulized with 3%-HSS in asthmatic children, compared to albuterol nebulized with NSS.Population and Methods: In a prospective, experimental, double-blind, randomized clinical study, children with a confirmed diagnosis of asthma with mild or moderate bronchial obstruction (FEV 1 40%-79% of predicted) were randomized to receive a nebulization with 2.5 mg of albuterol diluted in 3 cc of 3%-HSS or NSS (0.9%), by means of a jet nebulizer. After 30 min, the BDR was assessed.Results: Fifty patients (mean age 12.0 ± 3 years, 29 males) were enrolled; 25 were randomized to the 3%-HSS group (FEV 1 65.2% ± 10) and 25 to the NSS group (FEV 1

Expert group recommendation on inhaled mucoactive drugs in pediatric respiratory diseases: an Indian perspective

“…Asthma is an inflammatory chronic airway disease characterized by bronchial hyperresponsiveness and airflow obstruction. Wheezing, mucus hypersecretion, and mucus plugging are reported in patients with asthma, especially during exacerbations ( 37 ). Short-acting beta2-agonist bronchodilators, such as salbutamol and systemic corticosteroids, are usually advised for asthma exacerbations ( 37 ).…”

“…Wheezing, mucus hypersecretion, and mucus plugging are reported in patients with asthma, especially during exacerbations ( 37 ). Short-acting beta2-agonist bronchodilators, such as salbutamol and systemic corticosteroids, are usually advised for asthma exacerbations ( 37 ). It has also been seen that salbutamol produced a greater bronchodilator response (FEV1 and maximum mid-expiratory flow) when inhaled with 3% HS vs. NS in asthmatic children with mild or moderate bronchial obstruction ( Table 4B ) ( 37 ).…”

Childhood asthma treatment based on indirect hyperresponsiveness test: Randomized controlled trial

“…It's worth pointing out that only in 5 cases out of about 400 tests performed in 2019 in our center, there was a mild, short‐term, reversible decrease in saturation (SpO 2 values 92%–93%) during bronchospasm. The safety of hypertonic saline inhalation is confirmed by its wide therapeutic use in patients with bronchiectasis, as well as in the AHR test, also in children with asthma 34,35 . The time needed for the AHR challenges is similar in both methods 21 …”

“…The safety of hypertonic saline inhalation is confirmed by its wide therapeutic use in patients with bronchiectasis, as well as in the AHR test, also in children with asthma. 34,35 The time needed for the AHR challenges is similar in both methods. 21 AHR is a promising tool for the treatment monitoring of mild-tomoderate asthma.…”

Pediatric pulmonology 2021 year in review: Asthma

“…To explore a new treatment option for asthma patients, Teper et al 9 performed a prospective double‐blind, randomized, placebo control study comparing albuterol nebulized with 3% hypertonic saline (HTS; n = 28) to traditional albuterol mixed with normal saline (NS; n = 28). Spirometry was performed 30 min after nebulizer treatment with >12% change in FEV 1 considered significant.…”