Denjean A, Guimaraes H, Migdal M, Miramand J L, Dehan M, Gaultier C
Laboratory of Physiology INSERM CJF 89.09, Clamart, France.
J Pediatr. 1992 Jun;120(6):974-9. doi: 10.1016/s0022-3476(05)81973-0.
We used a placebo-controlled standardized protocol to define the dose-response relationship to the beta-adrenergic bronchodilator salbutamol (albuterol) in 10 ventilator-dependent premature infants at a postnatal age of 13.3 +/- 4.9 days. Passive respiratory system resistance and compliance were measured at baseline and 10 minutes after administration of salbutamol via a metered-dose inhaler and spacer device. Salbutamol caused a significant dose-related response with a 33% mean decrease in respiratory system resistance (p less than 0.05) and a 67% mean increase in respiratory system compliance (p less than 0.001). In seven and six patients, respectively, 100 micrograms of salbutamol caused significant improvement in resistance and compliance; 200 micrograms was required in the remainder, but one patient had no improvement in compliance. Oxygen saturation increased linearly with the increase in compliance. In 7 of the 10 infants, the duration of action of 200 micrograms of salbutamol on the following day was 3 hours. We conclude that bronchodilator treatment may be useful in the management of ventilator-dependent neonates with respiratory distress syndrome.
我们采用安慰剂对照的标准化方案，对10名出生后13.3±4.9天、依赖呼吸机的早产儿进行了β-肾上腺素能支气管扩张剂沙丁胺醇（舒喘宁）的剂量反应关系研究。在基线时以及通过定量吸入器和储雾罐装置给予沙丁胺醇10分钟后，测量被动呼吸系统阻力和顺应性。沙丁胺醇引起了显著的剂量相关反应，呼吸系统阻力平均降低33%（p<0.05），呼吸系统顺应性平均增加67%（p<0.001）。分别在7名和6名患者中观察到，100微克沙丁胺醇使阻力和顺应性有显著改善；其余患者则需要200微克，但有1名患者的顺应性未得到改善。氧饱和度随顺应性的增加呈线性升高。在10名婴儿中的7名中，200微克沙丁胺醇次日的作用持续时间为3小时。我们得出结论，支气管扩张剂治疗可能有助于管理患有呼吸窘迫综合征的依赖呼吸机的新生儿。
