Nebulized Salbutamol for Treatment of Transient Tachypnea of the Newborn: A Randomized Placebo-controlled Clinical Trial in Iran

Background: Transient tachypnea of the newborn (TTN) is caused by insufficient or delayed fetal lung fluid clearance, leading to ineffective gas exchange, respiratory distress, and tachypnea.  Objectives: This study aimed to investigate the effect of nebulized salbutamol on different severities of TTN in newborns. Methods: This is a randomized double-blind, placebo-controlled, clinical trial on ۶۴ neonates with TTN admitted to the neonatal intensive care units of Bouali and Imam Khomeini tertiary hospitals in Sari, north of Iran. They were divided into two groups (۳۲ per group): The salbutamol group, which received ۰.۱ mL of nebulized salbutamol (ventolin, salbutamol sulfate ۵ mg/mL) in ۳ mL of normal saline ۰.۹%; and the placebo group, which received ۲ mL of ۰.۹% nebulized saline as a placebo. The severity of TTN was determined based on the Silverman-Andersen respiratory severity (RSS) score. Data were analyzed in SPSS software, version ۲۳, and P<۰.۰۵ was considered statistically significant. Results: Among ۶۴ neonates, ۴۹(۷۶.۵۶%) were male. The mean weight was ۳۰۷۱±۶۸۹ and ۳۱۳۹±۵۳۹ grams in the placebo and salbutamol groups, respectively. There was no significant difference in the total RSS before treatment (۶.۲۵±۱.۶۸۵ vs ۵.۷۵±۱.۷۴۱; P=۰.۲۴۸) between groups, but it declined significantly after treatment (۱.۰۹±۰.۹۹۵ vs ۱.۹۴±۱.۵; P=۰.۰۱۰). The length of hospital stay and duration of respiratory support were significantly shorter in the salbutamol group compared to the placebo group (P<۰.۰۰۱), but there was no significant difference in the age at initiation of feeding. Conclusions: The use of nebulized salbutamol can improve the condition of transient dyspnea in neonates with lower (RSS ≤۶) or higher (RSS >۶) TTN severity.

Keywords:

Transient tachypnea of the newborn (TTN) , Salbutamol nebulizer , Silverman-Andersen respiratory severity (RSS) score