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There are two schools of thought regarding dosing of albuterol and other nebulized medications. One approach recognizes that a younger, smaller child has a lower minute ventilation than a larger child and therefore should self-regulate delivery of drug. The second approach is to dose based on weight. As far as I know, there are no data to support one method over another, but perhaps list members know of of studies that I am not aware of. What these approaches look like in practice:

1. Minute ventilation:
10 kg child: 8 cc/kg tidal volume x 10 kg x 40 bpm = 3.2 lit
30 kg child: 8 cc/kg x 30 x 20 bpm = 4.8 lit
Presumably, a greater proportion of the drug placed in the reservior will be inhaled by the child with the greater minute ventilation, so it would not be unreasonable to place the same amount for children of all ages.

2. Weight:
10 kg: 0.15 mg/kg x 10 = 1.5 mg
30 kg: 0.15 mg/kg x 30 = 4.5 mg

>>> "Raftos, Jeremy (PAED_EMER)" <[log in to unmask]> 09/17 2:03 AM >>>
We use only 2 doses 0.5ml <than 5 and 1ml > 5. However we are now use puffer
and spacer for all but severe cases .5puffs <than 5 yrs 10puffs 5-10 yrs and
12 puffs>than 10yrs
Regards
Jeremy Raftos
Adelaide
South Australia

        ----------
        From:  Robin Larabee
        Sent:  Friday, 14 September 2001 02:56
        To:  [log in to unmask]
        Subject:  Albuterol Dosing

        Seems trivial after tuesday's events...
        But I've been wanting to ask the group how you dose albuterol for
pediatric asthma:
        a) Do you give everyone a "unit dose"
        b)or Do you dose based on weight or age (0.25cc-0.5cc-0.75cc-1.0cc,
etc).

        Regardless of where you begin your dosing, do you up the dose for
patients who don't respond well to a few nebs at your initial dose?
        I have seen literature supporting all points of view, and am trying
to find a consensus.  Thanks!
        Please respond to me privately and I will post results to the group.
        Robin Larabee
        peds hospitalist, Baltimore

        For more information, send mail to [log in to unmask] with
the message: info PED-EM-L
        The URL for the PED-EM-L Web Page is:

http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html