From the Guidelines
Albuterol (Salbutamol) is useful in acute chest syndrome, particularly in patients with underlying asthma or bronchoconstriction.
Key Points
- The evidence suggests that inhaled bronchodilators, such as albuterol/salbutamol, are effective in patients with asthma and acute shortness of breath 1.
- Albuterol/salbutamol can be safely administered with no clinically significant change in heart rate, blood pressure, or other side effects 1.
- The recommended dose of albuterol/salbutamol is 2.5 mg by nebulization over 20 minutes, which may be repeated hourly as needed 1.
- Bronchodilators, including albuterol/salbutamol, may improve cardiac function in patients with acute heart failure (AHF) and concomitant lung problems, but should not be used instead of relevant AHF treatment 1.
- Heliox-driven albuterol nebulization can also be considered in patients with acute asthma, as it may help decrease the work of breathing 1.
Administration
- Albuterol/salbutamol can be administered using a metered-dose inhaler with a spacer device, which improves drug delivery to the lungs 1.
- Improvised spacers made with a plastic bottle or paper cup can provide similar drug delivery to commercial spacer devices 1.
- Nebulized albuterol/salbutamol can also be used, particularly in patients with severe asthma or those who are unable to use a metered-dose inhaler 1.
From the Research
Albuterol (Salbutamol) in Acute Chest Syndrome
- The effectiveness of albuterol (salbutamol) in acute chest syndrome is not directly addressed in the provided studies, as they focus on its use in acute respiratory distress syndrome (ARDS), chronic obstructive pulmonary disease (COPD), and acute asthma.
- However, the studies provide insight into the use of albuterol in respiratory conditions, which may be relevant to acute chest syndrome.
- A study on ARDS found that treatment with albuterol was not effective in increasing survival, but significantly decreased ventilator-free days and organ failure-free days 2.
- Another study on ARDS found that intravenous infusion of salbutamol increased 28-day mortality and was poorly tolerated 3.
- In contrast, studies on COPD and acute asthma found that short-acting inhaled bronchodilators like salbutamol (albuterol) were useful in improving symptoms and lung function 4, 5, 6.
- The use of albuterol in acute chest syndrome may be informed by its effects in these related conditions, but further research is needed to determine its efficacy and safety in this specific context.