Currently several dose schedules of Albuterol are administered via nebulization to infants in
the neonatal and infant intensive care unit (N/IICU). As Albuterol is not FDA approved for
this population (under 2 years) there is no standard recommended dose. Aerosolized Albuterol
is one of the most widely used therapies that are utilized for infants with chronic lung
disease. The common practice in the N/IICU is weight base dosing of all medications. This
contradicts the aerosol science recommendations, which advise not to titrate doses by weight
as the patient naturally self-regulates their dose according to the change in minute
ventilation with age. In addition, the wide use of aerosolized Albuterol in the infant with
Bronchopulmonary Dysplasia (BPD) has little current evidence of efficacy in this disease.
Understanding the appropriate dose for effective treatment as well as the indication for use
in the BPD population would provide the clinician with useful guidelines.
The investigators propose to analyze the safety and efficacy of aerosolized albuterol in
infants with BPD comparing the recommended dose per aerosolization literature with the common
dosing practices at The Children's Hospital of Philadelphia (CHOP) as well as placebo.