Background: Bronchiolitis is an acute, viral infection and it is one of the common causes of hospitalization in infants. The treatment is mainly supportive. The use of bronchodilators is usually not recommended, but some cases can benefit from the administration of salbutamol.

Aim: To investigate the efficacy of salbutamol treatment with the analysis of Tidal breath analysis technique in infants with bronchiolitis.

Methods: We enrolled 11 infants (7 males) aged 0- 12 months hospitalized for bronchiolitis at Sapienza University of Rome. We performed TB analysis for each patient (T0) and then within one hour after a trial with inhaled salbutamol (T1). For each patient vital signs, physical examination, and family history were recorded using clinical charts.

Results: At T0, 5 patients presented a normal ratio of time to peak tidal expiratory flow to total expiratory time (tPTEF/TE), none of them had an increase in the tPTEF/TE ratio at T1, after the salbutamol trial. Six patients had a tPTEF/TE reduced (median 16.34, range 11.00?21.58). At T1, five (83.3%) showed an improvement of the ratio (median increase of tPTEF/TE 42.86%, range 19.95%-173.89%) and two reached normal values. A positive response to salbutamol was associated with the presence of wheezing at chest auscultation (83.3% vs 16.7% p=0.015). Rales on physical examination of the chest where more frequent in the non-responder group (33.3% vs 66.6%, p=0.182). We found no association between the response to salbutamol and family history of pre-school wheezing or atopy.

Conclusion: Our study demonstrated that some infants with bronchiolitis can benefit from a treatment with inhaled salbutamol.