Aerosolized Albuterol Use in Severe BPD

This is a randomized, blinded cross-over study of infants with a diagnosis of Severe BPD that are mechanically ventilated. Participants will receive 3 sets of treatment (2.5mg Albuterol, 1.25mg Albuterol, 3ml normal saline placebo), in random order. Each treatment will be administered every 4 hours for 24 hours. After a 6 hour washout phase, the next group of interventions will be applied. Following another wash-out phase, the final group of intervention will be applied. Pulmonary mechanics from the ventilator (e.g. airway compliance, airway resistance, tidal volume, peak inspiratory pressure, Forced Expiratory Flow at 75% of forced vital capacity, etc.) and the patient short term response to therapy (heart rate, blood pressure, heart rhythm) will be assessed for the duration of the treatment period.

Inclusion criteria

• Infants greater than or equal to 36 weeks corrected gestational age to one year of age
• Diagnosis of BPD in accordance with The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) definition
• May have a current order for short acting bronchodilator, not required
• May have congenital anomalies unless one or more of the exclusion criteria are met, not required
• Receiving conventional mechanical ventilation via an artificial airway (endotracheal tube or tracheostomy) via Draeger V500 Ventilator
• Parental/guardian permission (informed consent)

Exclusion criteria

• Airway leak greater than 10%
• Unilateral lung disease
• Current order for inhaled anticholinergic (i.e. ipratropium bromide)
• Active pulmonary or systemic infection
• Scheduled order for other medication that cause bronchodilation (i.e. atrovent, magnesium sulfate, ketamine, etc.)