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Thread: Low Oxygen Saturation After Albuterol (Infant)

  1. #1
    Junior Member
    Join Date
    Mar 2018
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    Low Oxygen Saturation After Albuterol (Infant)

    Hi everyone!

    I hope it's okay that I am posting here- my son doesn't have CF, but he was diagnosed with Primary Ciliary Dyskinesia when he was two weeks old. He spent his first 2 weeks in the NICU for respiratory distress. Unfortunately, PCD treatment is based on CF management because so little is known about it. PCD manifests itself very similarly to CF but has different causes. He is 2 months old now on home oxygen at night, albuterol and hypertonic saline twice a day, and CPT 2-3 times daily.

    During the past month, during his hypertonic saline treatment, his O2 has dropped to low 80's. I stop the treatment, let him recover and start back up again. This happens frequently during the remainder of the treatment. It doesn't make a difference whether he is on room air or his oxygen. I always assumed it was the saline, but I tried just giving him the saline without the albuterol first, and his did not have any low desats (just to mid 90's briefly). He was also on room air. So, now I'm thinking it was the albuterol (maybe causing bronchoconstriction?).

    Does anyone have any experience or insight on this? I mentioned this to his pulmonologist, and all he said was to do the albuterol twice a day and the saline half as much once a day (this was when I thought it was the albuterol). Very frustrating... I am under the impression that the hypertonic saline is more important for mucus clearing than the albuterol, if he is only able to tolerate one.

  2. #2
    Senior Member
    Join Date
    Sep 2016
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    What strength of hypertonic saline is he on(7%, 5%, 3%)? The reason I ask is because some CF patients can't tolerate it or have to use lower doses because it's too harsh for us and can cause our airway to restrict. This happens to me when I take the 7% and we have now bumped me down to the 3% with no issues. Albuterol is important because it opens up the airways allowing mucus to move through. Also see if maybe Pulmozyne is an option for him. It does the same thing as hypertonic saline, however, there isn't a salt component to it that dries out the mucus.

  3. #3
    Hi,
    I was diagnosed with PCD at 49 (2 recessive genes). My health issues did not begin until around age 4 and obviously the treatments were lacking. Just thought I would mention that I can not tolerate albuterol and other inhaled therapies because of SOB. I have had better success with Atrovent, but am not sure it can be used for infants. I am okay with 3% saline occasionally and recently tried 7% ph balanced saline to see if that would help (not great). I was able to nebulize Cayston for around 5 years with the E-Flow - which has a very short delivery time.

    I understand your frustration and thought I would mention that PCD has a new clinical trial - CLEAN PCD. While your child is too young right now, it does seem promising for the future. Best wishes!

  4. #4
    Super Moderator
    Join Date
    Apr 2006
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    20,880
    DS has been on atrovent and albuterol nebs since he was an infant -- a week or so old. It's my understanding atrovent is longer lasting, whereas, albuterol is a more immediate, short term bronchodilator.
    Parent to a child wcf double delta f508.

    Started Orkambi July 2015
    Began Symdeko August 2018

  5. #5
    After using albuterol for decades, I got to the point where is was causing SOB and low sats and I could no longer tolerate it. Granted, I could not tolerate any other inhaled medication at that point either except simple saline. I could tolerate Advair however.
    DDf508, 46 years old, 2 daughters (ages 16 and 12). CFRD, GERD. Married 20+ years. Transplanted at Duke 10/12/17.

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