Salbutamol Infusion Protocol

Available Product: 

• Injection Salbutamol 0.5mg/ml (1ml ampoules)

Diluents recommended: 

• Sodium Chloride and Dextrose Injection, Water for Injections, Sodium Chloride Injection or Dextrose Injection

This recommendation is based on available product information leaflets

For administration via peripheral line

• The maximum concentration for infusion differs according to products
• Most products recommend 10mg Salbutamol in 50ml diluents (0.2mg/ml)
• No information is stated on the product leaflet (generic) used in Hospital Keningau. According to the company representative, the recommendations are based on the original product Ventolin®, which also states the maximum concentration is 0.2mg/ml
• Some also recommends to use lower concentration- 0.01mg/ml to 0.02mg/ml

Need for Dilution

• Recommendation from Injection Ventolin 1mg/ml – the injections has to be diluted at least by 50% before administration. Extrapolating from the recommendation, the max concentration has to be at least 0.5mg/ml

Central line

• Based on the PICU guidelines, a maximum concentration of 0.5mg/ml can be given via the central line.
• Common Practices (not supported by evidence)
• 1mg/kg injection Salbutamol in 50ml diluents (up to 50ml)
• This would provide an equivalence of 1ml/hr= 20mcg/kg/hour=0.33mcg/kg/min

Based on the dosing guide:

5-10mcg/kg/min for 1 hour followed by 1-2mcg/kh/min (Drug Doses)

1-2mcg/kg/min and adjust according to response and heart rate up to 5mcg/kg/min

(doses above 2mcg/kg/min are given at intensice care unit) (BNF 2013)

0.33mcg/kg/min (20mcg/kg/hour) and Up to a max of 2mcg/kg/min (60mcg/kg/hour)

References:

1. BNF for Children 2013
2. www.lexi.comp
3. Drug Doses, Frank Shann
4. http://www.drugs.com/uk/pdf/leaflet/474844.pdf
5. PICU, Nottingham Childrens' Hospital https://www.nuh.nhs.uk/media/1216339/salbutamol_v2.pdf
6. http://www.medsafe.govt.nz/profs/datasheet/v/VentolininjIV.pdf