Files and links (1)
Published, Version of Record (VoR)Open Access (License Unspecified), Open
Journal article
Effectiveness and Safety of Albuterol Solutions With and Without Benzalkonium Chloride
Respiratory care, v 68(6), pp 734-739
01 Jun 2023
PMID: 36669780
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
INTRODUCTION: Continuous aerosolized b2 agonist, namely albuterol, is the most commonly used therapy for critical asthma. Benzalkonium chloride is a preservative present in some formulations of aerosolized albuterol solutions that can induce bronchospasm. Recent studies have shown that inhalation of albuterol containing benzalkonium chloride might induce unintended bronchoconstriction and poor outcomes. This study aimed to investigate whether using albuterol solutions containing benzalkonium chloride results in prolonged hospital length of stay (LOS). METHODS: This was a retrospective cohort study of pediatric subjects admitted to the pediatric ICU (PICU) and treated with continuous albuterol. Data were collected and compared before and after a change to benzalkonium chloride-containing solutions. Subjects who were treated with preservative-free solutions were used as control. The primary outcome was PICU and hospital LOS; secondary outcomes included the duration of continuous albuterol and use of adjunctive therapies. RESULTS: A total of 266 admissions were included in the study. One hundred forty subjects (52.6%) were exposed to benzalkonium chloride. Median age and severity of illness scoring were similar between groups. The initial dose of continuous albuterol was significantly higher in the benzalkonium chloride group (median 15 interquartile range [IQR] 10-20 mg/h) compared to the preservative-free group (median 10 IQR 10-20 mg/h) (P < .001). PICU LOS was longer for the preservative-free group, 2.5 (IQR 1.4-4.6) d vs 1.8 (IQR 1.1-2.9) d for benzalkonium chloride group (P = .002). There was no significant difference in duration of continuous albuterol therapy (P = .16) or need for adjunctive respiratory support (heliox [P = .32], noninvasive ventilation [P = .81], and invasive mechanical ventilation [P = .57]). CONCLUSIONS: In contrast to published literature showing that benzalkonium chloride may be associated with a longer duration of continuous albuterol nebulization and hospital LOS, our study demonstrated that benzalkonium chloride-containing albuterol is safe for continuous nebulization in critically ill children and not associated with worse outcomes.
Metrics
Details
- Title
- Effectiveness and Safety of Albuterol Solutions With and Without Benzalkonium Chloride
- Creators
- Awni M. Al-Subu - College Station Medical CenterEric Friestrom - University of Wisconsin HealthErica Terry - Lucile Packard Children's HospitalMiranda R. Langkamp - University of Wisconsin American Family Children's HospitalCarolyn K. Adams - University of Wisconsin American Family Children's HospitalRhonda A. Yngsdal-Krenz - University of Wisconsin–MadisonMichael R. Lasarev - University of Wisconsin–MadisonRyan L. DeSanti - Drexel UniversityJoshua P. Vanderloo - University of Wisconsin HealthMonica C. Bogenschutz - University of Wisconsin American Family Children's Hospital
- Publication Details
- Respiratory care, v 68(6), pp 734-739
- Publisher
- Daedalus Enterprises Inc
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:001028407000005
- Scopus ID
- 2-s2.0-85160199537
- Other Identifier
- 991021463453504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Respiratory System