What is the recommended volume of salbutamol (albuterol) nebule solution for a 3-month-old infant?

Salbutamol Nebulizer Dosing for a 3-Month-Old Infant

For a 3-month-old infant with acute bronchospasm or asthma exacerbation, administer 2.5 mg of salbutamol (half the standard pediatric dose) via oxygen-driven nebulizer, which equals 2.5 mL of standard nebulizer solution. 1

Standard Dosing Guidelines

The British Thoracic Society guidelines specifically recommend half doses in very young children when treating acute severe asthma 1:

• Standard pediatric dose: 5 mg salbutamol via nebulizer
• Very young children (including 3-month-old infants): 2.5 mg salbutamol via nebulizer 1

Volume Calculation

Since standard salbutamol nebulizer solution contains 5 mg per 2.5 mL (or 2.5 mg per 1.25 mL in some formulations):

• 2.5 mg dose = approximately 1.25-2.5 mL depending on the concentration of your specific nebulizer solution 1
• Always check your institution's specific salbutamol nebulizer concentration to calculate the exact volume

Administration Protocol

Initial treatment 1:

• Administer via oxygen-driven nebulizer (not air-driven)
• Can repeat every 20-30 minutes if needed for severe bronchospasm 1
• Maximum frequency: up to every 30 minutes during acute exacerbations 1

Concurrent therapy 1:

• Always administer with high-flow oxygen via face mask
• Consider adding ipratropium bromide 100 mcg nebulized every 6 hours for severe cases 1
• Administer systemic corticosteroids (intravenous hydrocortisone) simultaneously 1

Critical Safety Considerations

Important caveats for infants under 6 months 1:

• Assessment in very young infants may be difficult
• Monitor for signs of respiratory distress: too breathless to feed, respirations >50/min, pulse >140/min 1
• Maintain oxygen saturation >92% with continuous oximetry monitoring 1

Monitoring requirements 1:

• Reassess response 15-30 minutes after initial nebulization
• If not improving, increase frequency to every 30 minutes 1
• Prepare for ICU transfer if deterioration occurs despite treatment 1

Common Pitfalls to Avoid

• Do not use adult doses (5 mg) in very young infants—always use half doses 1
• Do not delay corticosteroid administration—steroids should be given simultaneously, not after failed bronchodilator therapy 1
• Do not use air-driven nebulizers—oxygen-driven nebulizers are essential in acute settings 1
• Do not use salbutamol as monotherapy—always combine with oxygen and consider ipratropium for severe cases 1