Background: Short-acting beta(2)-agonists have shown beneficial effects in preterm infants, but data on long acting beta(2)-agonists are still lacking.
Objectives: To compare the effects of inhaled formoterol with salbutamol in preterm infants.
Methods: Randomized, double-blind, crossover design of salbutamol (100 microg every 6 h) or formoterol (12 microg every 12 h) delivered by metered dose inhaler on two consecutive days to very low birth weight infants on assisted mechanical ventilation (n=12; gestational age 25.7+/-2 weeks; birth weight 720+/-254 g; postnatal age 25+/-9 days; mean+/-SD). Treatment with the second drug was administered until day 7 in eight infants. Outcome variables were minute volume MV, respiratory mechanics, heart rate HR, blood pressure, serum potassium and blood glucose levels.
Results: Mean MV increased by maximal 26% (salbutamol) and by 22% (formoterol) differing from baseline values until 6 and 8 h through increased mean tidal volume (Vt) in both groups (max. 14%). Mean static compliance (Crs) increased by 26% (salbutamol) and by 32% (formoterol) until 60 min post-administration. There was no tachyphylaxis.
Conclusion: Inhaled salbutamol and formoterol equally increase MV, Vt, Crs and HR in mechanically ventilated infants with a longer lasting systemic effect of formoterol.