• Crit Care · Apr 2002

    Randomized Controlled Trial Clinical Trial

    Tidal breathing flow-volume loops in bronchiolitis in infancy: the effect of albuterol [ISRCTN47364493].

    • Balagangadhar R Totapally, Cem Demerci, George Zureikat, and Brian Nolan.
    • Division of Critical Care Medicine, Miami Children's Hospital, Florida, USA. bala.totapally@mch.com
    • Crit Care. 2002 Apr 1; 6 (2): 160-5.

    ObjectivesTo evaluate the effect of nebulized albuterol on tidal breathing flow-volume loops in infants with bronchiolitis due to respiratory syncytial virus.DesignA randomized, double-blind, control study.SettingPediatric unit in a community teaching hospital.ParticipantsTwenty infants younger than 1 year of age (mean age, 5.8 +/- 2.8 months) with a first episode of wheezing due to respiratory syncytial virus bronchiolitis.InterventionsChloral hydrate (50 mg/kg) was administered orally for sedation. One dose each of nebulized albuterol (0.15 mg/kg in 3 ml saline) and saline (3 ml) were given at 6 hour intervals in a random order.MeasurementsTidal breathing flow-volume loops were obtained before and after each aerosol treatment with a Neonatal/Pediatric Pulmonary Testing System (Model 2600; Sensor Medics, Anaheim, CA, USA). At the same time, the fraction of tidal volume exhaled at peak tidal expiratory flow (PTEF) to total tidal volume (VPTEF/VE), and the fraction of exhaled time at PTEF to total expiratory time (tPTEF/tE) were measured. The PTEF, the tidal expiratory flows at 10%, 25%, and 50% of the remaining tidal volume (TEF10, TEF25, and TEF50), and the wheeze score were also determined.ResultsThere were no significant changes in VPTEF/VE and tPTEF/tE after albuterol or saline treatment. PTEF increased significantly both after albuterol and saline treatments but the difference between the two treatments was not significant (P = 0.6). Both TEF10 and the ratio of the tidal expiratory flow at 25% of the remaining tidal volume to PTEF (25/PT) decreased significantly (P < 0.05) after administration of albuterol. All other investigated variables were not significantly affected by aerosol administration.ConclusionsNebulized albuterol in infants with mild bronchiolitis due to respiratory syncytial virus did not improve VPTEF/VE and tPTEF/tE but did decrease TEF10 and 25/PT.

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