Abstract
Background and aims: Albuterol derivativesare commonly used in the NICU to relieve airwayconstriction. Conventionally, these drugs aredelivered while the patient is on a ventilator, or byface mask in non-intubated patients; however, forinfants on HFNC the ability to deliver through thenasal prongs would limit discontinuation of therapyduring drug dosing. The aim is to demonstrate thatdelivery of an aerosolized dose of Levabuterolthrough a HFNC system is feasible.
Methods: Two preterm infants were treated withXopenex® aerosolized by 1) a small volume aerosol(tri-Anim) and airlife connector (Allegiance) while ona ventilator prior to extubation (VENT), and 2) afterextubation using an ultrasonic nebulizer (Aerogen)on a HFNC system (Vapotherm Precision Flow™). Data for heart rate (HR), respiratory rate (RR), core temperature, FIO2, SaO2 and the ratio ofFIO2:SaO2 were recorded 30 min before and 30minutes after the administration.
Results: Both patients responded to the treatmentsin a similar manner. For both patients the HRincreased by 12 bpm on VENT and 10 bpm withHFNC; RR decreased 6 br/min on VENT and 11 br/min with HFNC; core temperature decreased 0.16°Con VENT and increased 0.01°C with HFNC; FIO2decreased 3.5% on VENT and 2.89% with HFNC;SaO2 increased 0.39% on VENT and 0.33% withHFNC; FIO2:SaO2 decreased 0.04 on VENT and0.03 with HFNC.
Conclusions: Levabuterol delivery through aHFNC appears to have the same physiologic impactas delivery through a respirator. A larger study iswarranted to substantiate these findings.
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Rojas, J., Cortez, J. & Miller, T. 1334 Feasibility Trial for the Delivery of Levabuterol to an Infant Through an Adapted High Flow Nasal Cannula (HFNC) System. Pediatr Res 68 (Suppl 1), 660 (2010). https://doi.org/10.1203/00006450-201011001-01334
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DOI: https://doi.org/10.1203/00006450-201011001-01334