Increased compliance in response to salbutamol in premature infants with developing bronchopulmonary dysplasia

Rotschild, Avi; Solimano, Alfonso; Puterman, Martin L.; Smyth, J. T.; Sharma, Anil; Albersheim, Susan

doi:10.1016/s0022-3476(89)80755-3

Cited by 76 publications

(40 citation statements)

References 25 publications

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“…This infant had a positive response to albuterol in onstrate airway responsiveness was not real ized, as we found no specific time at which infants began to demonstrate improvements after nebulization of a ß-agonist. Again, this finding is consistent with Rotschild et al [12], who found that improvement was not significantly related to characteristics such as gender, birth weight, gestational age, PNA or disease severity. While there was a posi tive response (improvement in tidal volume and dynamic compliance) to albuterol in 62% of the paired evaluations, this overall responsiveness of the group was due pri marily to individual infants who responded to ß-agonists the majority of the time.…”

Section: Testing Proceduressupporting

confidence: 91%

“…Airway responsiveness and improvement in pulmonary function after bronchodilator nebulization recently have been demon strated in a number of studies of infants with chronic lung disease [7][8][9][10][11][12], Our findings confirm, that some preterm infants can re spond to ß-agonists with resultant improve ments in tidal volume and compliance. However, similar to findings of Rotschild et al [12], we did not see a consistent decrease in airway resistance when improvement oc curred in tidal volume and compliance.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Use of a Beta-Agonist in Ventilated, Very-Low-Birth-Weight Babies: A Longitudinal Evaluation

Kovacs¹,

Fisher²,

Brodsky³

et al. 1990

Dev Pharmacol Ther

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To determine if there is a specific postnatal (PNA) or postconceptional age (PCA) at which ventilated preterm infants respond to β-agonists, we evaluated 15 infants with a mean gestational age of 26.5 ± 1.5 weeks and mean birth weight of 0.89 ± 0.23 kg who required mechanical ventilation at 10 days of age. Weekly pulmonary function testing (PFT) was performed before and 1 h after administration of albuterol. Taking the group as a whole, as well as individual babies, regression analysis showed no relationship between positive response and either PNA or PCA. Evaluation of individual infants, however, showed that some consistently responded to ß-agonists whereas others did not. We recommend individual PFT to identify those infants who will benefit from use of β-agonists.

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Section: Testing Proceduressupporting

confidence: 91%

Section: Discussionsupporting

confidence: 77%

Use of a Beta-Agonist in Ventilated, Very-Low-Birth-Weight Babies: A Longitudinal Evaluation

Kovacs¹,

Fisher²,

Brodsky³

et al. 1990

Dev Pharmacol Ther

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“…Bronchodilator aerosols are commonly used for the treatment of bronchiolar constriction associated with chronic lung disease of the newborns [1][2][3][4][5][6][7][8][9]. The aerosols may be delivered by a metered dose inhaler (MDI) used in conjunction with a spacer device, a jet nebulizer, or an ultrasonic nebulizer.…”

mentioning

confidence: 99%

Delivery of salbutamol to nonventilated preterm infants by metered-dose inhaler, jet nebulizer, and ultrasonic nebulizer

Fok¹,

Lam²,

Ng³

et al. 1998

Eur Respir J

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To identify the most efficient device for the delivery of bronchodilator aerosol to nonventilated preterm infants with chronic lung disease, we compared the metered dose inhaler (MDI) used in conjunction with a non-valved spacer, an ultrasonic nebulizer with a small medication cup, and two jet nebulizers. The subjects were enrolled in two double-blind randomized crossover studies. In study A (n=10), each infant was given a nominal dose of 200 microg of salbutamol by a MDI (Ventolin) at 4 h intervals, and in random sequence via an Aerochamber (Neonatal Aerochamber) with its one-way valve removed, an ultrasonic nebulizer with a small cone-shaped medication cup (Siemens Electronics), and a jet nebulizer (Side-stream). Their functional residual capacity (FRC) and static respiratory system mechanics were measured before, and at 15, 30, 60, and 120 min after aerosol delivery. Study B (n=10) was carried out in an identical manner, but with a different jet nebulizer (Hudson). In both studies, administration of salbutamol aerosol via the MDI Aerochamber or ultrasonic nebulizer resulted in a significantly greater reduction in respiratory system resistance than via jet nebulizers. Furthermore, the use of MDI Aerochamber or ultrasonic nebulizer was associated with a greater degree of post-treatment tachycardia and improvement in FRC. The bronchodilating effect of salbutamol delivered via the ultrasonic nebulizer appeared to be slightly greater than that via the MDI-Aerochamber, receiving significance only in Study B. We conclude that both the metered-dose inhaler used with a nonvalved Aerochamber and the ultrasonic nebulizer with a small medication cup are both more efficient than the jet nebulizers in preterm infants.

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“…Também tem sido muito estudado o uso de boncodilatadores inalatórios no tratamento da DBP. Os betamiméticos tem se mostrado muito eficazes quando utilizados no tratamento das crises de broncoconstrição de recém-nascidos com DBP 22 . Não se recomenda o seu uso com intervalos fixos e regulares, mas somente quando há necessidade.…”

Section: ) Broncodilatadoresunclassified

Bronchopulmonary dysplasia

Procianoy¹

1998

J Pediatr (Rio J)

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ResumoObjetivo: Apresentar uma revisão da literatura a respeito da displasia broncopulmonar.Métodos: Foram selecionados, através do Medline, os artigos mais significativos publicados na literatura sobre displasia broncopulmonar.Resultados: A presente revisão analisa os diferentes conceitos, a patogenia, a clínica, o tratamento e as medidas preventivas da displasia broncopulmonar.Conclusões: Displasia broncopulmonar é uma doença freqüen-te em recém-nascidos de muito baixo peso que desenvolvem doença de membrana hialina e necessitam ventilação mecânica. Os fatores patogênicos são prematuridade, oxigenioterapia, ventilação mecâ-nica, edema pulmonar e infecção. O tratamento consiste em manter uma boa oxigenação, controle hídrico, cuidados nutricionais, diuré-ticos, betamiméticos, xantinas e corticosteróides. A prevenção consta de controle da prematuridade, uso de esteróide pré-natal, superó-xido desmutase e corticosteróides pós-natal.J. pediatr. (Rio J.). 1998; 74 (Supl.1): S95-S98: displasia broncopulmonar, oxigênio, ventilação mecânica, prematuridade. AbstractObjective: To review the literature on bronchopulmonary dysplasia.Methods: The most important articles on bronchopulmonary dysplasia were selected through MEDLINE.Results: The present review analyzes the different concepts, pathogenesis, clinical presentation, treatment and prophylaxis of bronchopulmonary dysplasia.Conclusions: bronchopulmonary dysplasia is a frequent condition of very low birth weight infants with hyaline membrane disease who require mechanical ventilation. The pathogenic factors are prematurity, oxygen therapy, mechanical ventilation, pulmonary edema, and infection. Treatment is based on good oxygenation, fluid restriction, nutritional support, diuretics, betamimetic drugs, xanthines, and steroids. Prophylaxis includes avoiding prematurity and using pre-natal steroids, superoxide dismutase, and post-natal steroids.J. pediatr. (Rio J.). 1998; 74 (Supl.1): S95-S98: bronchopulmonary dysplasia, oxygen, mechanical ventilation, prematurity. IntroduçãoDisplasia broncopulmonar (DBP) foi descrita pela primeira vez em 1967 por Northway e colaboradores 1 . Todos os recém-nascidos descritos eram prematuros, tinham tido doença de membrana hialina, foram ventilados com pressão positiva intermitente e receberam altas concentrações de oxigênio inspirado. A doença, inicialmente, foi descrita em quatro estágios clínico-radiológicos distintos. Os estágios I e II eram indistinguíveis da doença de membrana hialina e ocorriam nos primeiros dez dias de vida. Os estágios III e IV caracterizavam a sua cronicidade, sendo, o quarto estágio, o mais severo, podendo persistir por mais de 28 dias.A incidência de DBP varia de 30% a 60 % em crianças com peso de nascimento abaixo de 1500 gramas e que necessitaram de ventilação mecânica 2,3 . DefiniçãoA definição inicial de DBP baseava-se nos achados radiológicos de um paciente que necessitasse cronicamente de ventilação mecânica.Posteriormente, Bancalari e colaboradores sugeriram que o diagnóstico de DBP fosse feito somente...

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Increased compliance in response to salbutamol in premature infants with developing bronchopulmonary dysplasia

Cited by 76 publications

References 25 publications

Use of a Beta-Agonist in Ventilated, Very-Low-Birth-Weight Babies: A Longitudinal Evaluation

Use of a Beta-Agonist in Ventilated, Very-Low-Birth-Weight Babies: A Longitudinal Evaluation

Delivery of salbutamol to nonventilated preterm infants by metered-dose inhaler, jet nebulizer, and ultrasonic nebulizer

Bronchopulmonary dysplasia

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