Effects of inhaled formoterol compared with salbutamol in ventilated preterm infants

Short-acting β ₂-agonists have shown beneficial effects in preterm infants, but data on long acting β ₂-agonists are still lacking. To compare the effects of inhaled formoterol with salbutamol in preterm infants. Randomized, double-blind, crossover design of salbutamol (100 μg every 6 h) or formoterol (12 μg 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. 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 (V _t) in both groups (max. 14%). Mean static compliance (C _rs) increased by 26% (salbutamol) and by 32% (formoterol) until 60 min post-administration. There was no tachyphylaxis. Inhaled salbutamol and formoterol equally increase MV, V _t, C _rs and HR in mechanically ventilated infants with a longer lasting systemic effect of formoterol.