Evaluation of inhaled beta-2 agonist in management of transient tachypnea of the newborn

Background Transient tachypnea of the newborn (TTN) is a common cause of early neonatal respiratory distress. It is due to delayed clearance of fetal lung fluid. Aim To evaluate the effect of inhaled salbutamol, a beta-2 adrenergic agonist (β2AA), in management of TTN and to detect any side effects as a result of using it Methods A total of 100 infants with TTN were randomly divided into two groups to receive either inhaled salbutamol (treatment group) or an equal volume of normal saline solution (placebo group) at the time of diagnosis. At enrollment (by the 6th hour), complete blood count, blood glucose, serum potassium (K+), arterial blood gasses, respiratory rate, heart rate, blood oxygen saturation (O 2 Sat), fraction of inspired oxygen (FiO 2 ), and TTN clinical score were determined for all patients. At 0.5, 1, and 4 h after drug administration, respiratory rate, heart rate, O 2 Sat, FiO 2 , and the clinical TTN score were recorded. At 4 h after treatment, arterial blood gasses, serum K+, and blood glucose levels were measured again. The duration of total respiratory support and the duration of hospitalization were recorded as well. Results No statistically significant differences existed between both groups in terms of gestational age, birth weight, gender, mode of delivery, Apgar score, or maternal risk factors. The duration of respiratory support and duration of hospitalization were significantly shorter in the treatment (salbutamol) group ( P < 0.0005, P < 0.0002, respectively). In the treatment (salbutamol) group; the respiratory rate, FiO 2 and TTN score were significantly lower after treatment ( P < 0.0001, P < 0.0000, P < 0.0000, respectively). Also the PaO 2 significantly increased ( P < 0.0000) with significant improvement in PH ( P < 0.0001) and significant reduction in PaCO 2 ( P < 0.03). However, there were no statistically significant differences in heart rates, serum K+, or glucose levels after treatment. Conclusion Inhaled salbutamol, a β2AA, was effective in reducing the duration of respiratory support and hospitalization in TTN, with no detected side effects.