The effect of inhaled salbutamol on the outcomes of transient tachypnea of the newborn

Abstract

Background: Transient tachypnea of the newborn (TTN) is a self-limiting disease that results from a reduction in the rate of lung fluid clearance in neonates. A delay in lung fluid absorption in neonates disrupts the transition from intrauterine to extrauterine life. Use of beta-adrenergic antagonists, such as salbutamol, accelerates lung fluid clearance. The current study aimed to evaluate the effect of inhaled salbutamol on the clinical progression of TTN treatment.

Methods: In the current triple-blind clinical trial, a total of 148 inpatients diagnosed with TTN were randomly divided into 2 groups. The treatment group (n = 74) received inhaled salbutamol and the placebo group (n = 74) received inhaled normal saline. The drug administration was started 6 h after birth and continued in the case of continued respiratory distress and the need for oxygen as adjuvant therapy for up to 72 h maximum after the initiation of treatment. To evaluate the response to treatment with inhaled salbutamol, we assessed the respiratory rate (RR), heart rate (HR), fraction of inspired oxygen (FIO2) level, and O₂ saturation at intervals of 30 min as well as 1 h and 4 h after drug administration. The results were compared between the groups.

Results: The results of the current study indicated a significant difference between the treatment and placebo groups in the treatment duration, hospitalization duration, need for continuous positive airway pressure therapy (CPAP), and time of oral feeding initiation. In addition, no complication was observed during the treatment. It is noteworthy that, following the improvement of disease symptoms and reduction of hospitalization. This reduction may decrease the treatment costs and anxiety of parents, which was associated with proper mental and economic outcomes.

Conclusion: Although, in the current study, drug administration was continued for 72 h maximum, the prescription of at most 4 doses of salbutamol may have had maximum efficiency in the remediation process. To evaluate the therapeutic role of inhaled salbutamol, further studies are recommended.

Keywords: Inhaled; Newborn; Salbutamol; Transient tachypnea.