Document Detail


Bronchodilator aerosol administered by metered dose inhaler and spacer in subacute neonatal respiratory distress syndrome.
MedLine Citation:
PMID:  8198418     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is increasing evidence that bronchodilators are effective in ventilator dependent preterm infants. The effects of single doses of salbutamol (400 micrograms), ipratropium bromide (72 micrograms), and placebo (four puffs) given by metered dose inhaler and spacer (MDIS) were examined in 10 ventilated preterm infants, with a mean birth weight of 800 g at a postnatal age of 1 week, who were suffering from respiratory distress syndrome. The agents were each given in an open, random design. Blood gases were measured and ventilatory efficiency index (VEI) and arterial/alveolar oxygen tension ratio (PaO2/PAO2) were calculated five minutes before and 30 minutes after administration. Heart rate and mean arterial blood pressure were noted. The mean PaO2 improved by 0.61 kPa and 0.69 kPa after salbutamol and ipratropium bromide, respectively and these changes were significantly greater than the 0.5 kPa fall seen with placebo. The mean arterial carbon dioxide tension fell by 0.98 kPa after salbutamol and 0.59 kPa after ipratropium bromide. After both salbutamol and ipratropium bromide, VEI improved significantly (by 23% and 20% respectively) but there was no significant change in the PaO2/PAO2, suggesting that respiratory mechanics and not ventilation/perfusion balance had improved after a single dose of bronchodilator. We conclude that both salbutamol and ipratropium bromide given by MDIS have useful short term effects in ventilator dependent neonates with respiratory distress syndrome. Precise dose regimens and long term effects remain to be worked out.
Authors:
H Lee; S Arnon; M Silverman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  70     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-29     Completed Date:  1994-06-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F218-22     Citation Subset:  IM    
Affiliation:
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
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MeSH Terms
Descriptor/Qualifier:
Aerosols
Albuterol / administration & dosage,  therapeutic use
Bronchodilator Agents / administration & dosage*
Female
Heart Rate / drug effects
Humans
Infant, Newborn
Infant, Premature
Ipratropium / administration & dosage,  therapeutic use
Male
Nebulizers and Vaporizers*
Respiratory Distress Syndrome, Newborn / drug therapy*
Respiratory Mechanics / drug effects
Chemical
Reg. No./Substance:
0/Aerosols; 0/Bronchodilator Agents; 18559-94-9/Albuterol; 60205-81-4/Ipratropium
Comments/Corrections

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