Tidal Breathing Responses to Albuterol and Normal Saline in Infants with Viral Bronchiolitis

The American Academy of Pediatrics recommends the use of an objective means of evaluating the response to a trial of bronchodilator therapy in viral bronchiolitis (VB), but there is an inherent subjectivity with the use of clinical assessments. The goal of this study was to explore the possibility of using respiratory inductive plethysmography (RIP) to serve as an objective measure of change in respiratory function in infants with VB receiving albuterol (ALB) therapy. This was a randomized, double-blind, placebo-controlled study in previously healthy infants hospitalized for VB. Study subjects randomly received either ALB (0.1 mg/kg) or normal saline (NS) by nebulization. RIP data were collected during clinically determined quiet sleep before and after treatment. We enrolled a total of 20 study subjects; 10 received ALB and 10 received NS. Mean tidal breathing measures did not change significantly in either group post-treatment. However, the phase angle fell by >40% of baseline in 3 ALB-treated subjects (30%) and 4 NS (40%)-treated subjects. Using RIP, we observed improvements in the respiratory function in a subset of infants treated with ALB and with NS. It is possible that NS itself has beneficial effects. Our results suggest that RIP can serve as an objective measure of respiratory function in studies of infant VB.