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

Background Bronchodilator responses among preterm infants are heterogeneous. Bedside measurements may identify responders. Study design Respiratory measurements (Resistance, Compliance, FiO 2 ) and pulse oximetry (SpO 2 ) 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 FiO 2 did not significantly differ. Percent time in hypoxemia (SpO 2 < 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 FiO 2 ; however, hypoxemia may be useful in evaluating albuterol response.