Albuterol responsiveness in infants with respiratory failure caused by respiratory syncytial virus infection.
OBJECTIVE
To assess the bronchodilator effect of inhaled albuterol in the acute stage of severe respiratory syncytial virus (RSV) infection.


METHODS
Prospective, nonrandomized study of previously healthy infants who underwent intubation and whose lungs were ventilated because of respiratory failure caused by RSV infection. Ten infants with an endotracheal tube in place and without lung disease were matched for age and weight and served as normal control subjects.


METHODS
Lung function tests, including respiratory mechanics by single-breath occlusion, small airway function by forced deflation, and lung volumes by nitrogen washout, were performed before and after inhalation of 900 micrograms albuterol by metered dose inhaler. Bronchodilator response was defined as a change of more than twice the coefficient of variation of repeated baseline measurements.


RESULTS
Twenty-three infants (mean +/- SE age = 4.2 +/- 1.1 months) were studied, of whom 20 (87%) had obstructive small airway disease, and 3 (13%) had exclusively restrictive lung function profiles. Ten of the infants with obstructive disease (50%) did not benefit from albuterol, and 9 (45%) had small but significant improvements in lung function. Deterioration of lung function was documented in 1 patient after albuterol inhalation.


CONCLUSIONS
Inhaled albuterol is of limited value as a bronchodilator in infants with RSV-induced respiratory failure and should be discontinued if a beneficial response cannot be observed.
Hammer
J
J
Division of Pediatric Critical Care, Children's Hospital of Los Angeles, University of Southern California School of Medicine 90027, USA.
Numa
A
A
Newth
C J
CJ
D000208:Acute Disease; D000420:Albuterol / Q000008:administration & dosage*; D004341:Drug Evaluation; D006801:Humans; D007223:Infant; D016014:Linear Models; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D012121:Respiration, Artificial; D012129:Respiratory Function Tests / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D018709:Statistics, Nonparametric
D000420:Albuterol