Inhaled epinephrine for the treatment of transient tachypnea of the newborn

Objective: Infants with transient tachypnea of the newborn (TTN) have relatively low levels of epinephrine, which is known to mediate fetal lung fluid absorption. Providing exogenous epinephrine could be a valuable diagnostic and therapeutic intervention for this common condition. Our primary objective was to determine if inhaled racemic epinephrine is safe for the treatment of TTN. Our secondary objective was to determine its efficacy. Study Design: We conducted a randomized, blinded, placebo-controlled pilot trial. Inhaled racemic epinephrine or placebo was administered to 20 newborns with TTN. Physiologic variables of cardiopulmonary function were measured during and after treatment. Result: No infant in either the treatment or control arm experienced an adverse event, including tachycardia or hypertension. We did not detect a difference between the two groups regarding rate of resolution of tachypnea. Conclusion: We did not observe any adverse effects of inhaled racemic epinephrine when administered for the treatment of TTN. Larger studies are necessary to determine efficacy.