title: Pulmonary mechanics following albuterol therapy in mechanically ventilated infants with bronchiolitis.
abstract: OBJECTIVE
  Bronchiolitis is a common cause of critical illness in infants. Inhaled β(2)-agonist bronchodilators are frequently used as part of treatment, despite unproven effectiveness. The purpose of this study was to describe the physiologic response to these medications in infants intubated and mechanically ventilated for bronchiolitis.
  
  
  METHODS
  We conducted a prospective trial of albuterol treatment in infants intubated and mechanically ventilated for bronchiolitis. Before and for 30 minutes following inhaled albuterol treatment, sequential assessments of pulmonary mechanics were determined using the interrupter technique on repeated consecutive breaths.
  
  
  RESULTS
  Fifty-four infants were enrolled. The median age was 44 days (25-75%; interquartile range (IQR) 29-74 days), mean hospital length of stay (LOS) was 18.3 ± 13.3 days, mean ICU LOS was 11.3 ± 6.4 days, and mean duration of mechanical ventilation was 8.5 ± 3.5 days. Fifty percent (n = 27) of the infants were male, 81% (n = 44) had public insurance, 80% (n = 41) were Caucasian, and 39% (n = 21) were Hispanic. Fourteen of the 54 (26%) had reduction in respiratory system resistance (Rrs) that was more than 30% below baseline, and were defined as responders to albuterol. Response to albuterol was not associated with demographic factors or hospitalization outcomes such as LOS or duration of mechanical ventilation. However, increased Rrs, prematurity, and non-Hispanic ethnicity were associated with increased LOS.
  
  
  CONCLUSIONS
  In this population of mechanically ventilated infants with bronchiolitis, relatively few had a reduction in pulmonary resistance in response to inhaled albuterol therapy. This response was not associated with improvements in outcomes.
authors: Department of Pediatrics, Connecticut Children's Medical Center, Hartford, CT 06106, USA. ccarrol@ccmckids.org
authors: Christopher L
authors: CL
authors: Carroll
authors: Kathleen
authors: K
authors: Sala
authors: Aaron R
authors: AR
authors: Zucker
authors: Craig M
authors: CM
authors: Schramm
mesh_terms: D000420:Albuterol / Q000627:therapeutic use*; D001988:Bronchiolitis / Q000188:drug therapy* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D012121:Respiration, Artificial
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol