Hypoxaemia after nebulised salbutamol inwheezy infants: theimportance ofaerosol acidity

Theeffect ofnebulised iso-osmolar, preservative free, butacidic salbutamolsolution was studied in34acutely wheezinginfants aged117months. Transcutaneous oxygen pressure (TcPO2) andoxygen saturation (So2) fell significantly during thefirst fiveminutes after nebulisation withfurther deterioration at1520minutes. Tenoftheseinfants werefollowedupforanother twohoursandshowed slight improvement. Evenafter thesecond hourTcPo2hadnotreached baseline values. Threemonthslater theresponse tosalbutamolandaplacebo ofequal acidity (pH3.9) wasstudied in11infants fromthesamegroup, nowfreeofsymptoms. Lungfunction tests wereincluded andshowedno significant changes inspecific conductance andvolume corrected maximumexpiratory flows(Vmax atfunctional residual capacity/thoracic gas