The role of albuterol in bronchiolitis is not well established although it is commonly used. We hypothesized that albuterol improves small airways function in bronchiolitis. We have studied nineteen infants under 1 year (mean age=5±2.8 mo) with first episode of wheezing who are RSV+ve, in a randomized, double blind, placebo-controlled, crossover design with nebulized albuterol (0.15mg/kg) and saline. Chloral hydrate 50 mg/kg p.o. was used for sedation. We obtained TBFV loops pre and post aerosol with 2600 Neonatal/Pediatric Pul Testing System (Sensor Medics Cal.) by the standard method. PTEF (peak tidal expiratory flow in ml/sec), V-PT [% of tidal volume(TV) to PTEF], T-PT (% of expiratory time to PTEF), and TEF50, TEF25, TEF10(tidal expiratory flow rates at 50, 25, 10% of TV) are measured as shown in the table. All values: mean ± SD.

Table 1
Full size table

Values of V-PT(0.22), T-PT(0.16) suggest obstructive airway disease. Small airways function did not improve with albuterol when compared with saline, and showed deterioration in TEF10 (p=0.0001) and TEF25 (p=0.0008). PTEF increased both with albuterol (p=0.005) and saline (p=0.0001) and the difference was not significant (p=0.6). Also in our study there were no changes in respiratory compliance and resistance, measured by single breath occlusion technique. We conclude that albuterol has no bronchodilator effect in infants with RSV+ve bronchiolitis.