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Acute paediatrics
Bronchodilation in infants with malacia or recurrent wheeze
  1. W Hofhuis1,
  2. E C van der Wiel1,
  3. H A W M Tiddens1,
  4. G Brinkhorst2,
  5. W P J Holland3,
  6. J C de Jongste1,
  7. P J F M Merkus1
  1. 1Department of Paediatrics, Division of Respiratory Medicine, Erasmus University Medical Centre, Sophia Children‘s Hospital, Rotterdam, Netherlands
  2. 2Department of Paediatrics, Medical Centre Alkmaar, Alkmaar, Netherlands
  3. 3Department for Experimental Medical Instrumentation, Erasmus University Medical Centre, Rotterdam, Netherlands
  1. Correspondence to:
    Dr W Hofhuis, Erasmus University Medical Centre, Sophia Children‘s Hospital, Room SB-2664, PO Box 2060, 3000 CB, Rotterdam, Netherlands;
    hofhuis{at}alkg.azr.nl

Abstract

Background: Controversy remains regarding the effectiveness of bronchodilators in wheezy infants.

Aims: To assess the effect of inhaled β2 agonists on lung function in infants with malacia or recurrent wheeze, and to determine whether a negative effect of β2 agonists on forced expiratory flow (V′maxFRC) is more pronounced in infants with airway malacia, compared to infants with wheeze.

Methods: We retrospectively analysed lung function data of 27 infants: eight with malacia, 19 with recurrent wheeze. Mean (SD) age was 51 (18) weeks. Mean V′maxFRC (in Z score) was assessed before and after inhalation of β2 agonists.

Results: Baseline V′maxFRC was below reference values for both groups. Following inhalation of β2 agonists the mean (95% CI) change in mean V′maxFRC in Z scores was −0.10 (−0.26 to 0.05) and −0.33 (−0.55 to −0.11) for the malacia and wheeze group, respectively.

Conclusions: In infants with wheeze, inhaled β2 agonists caused a significant reduction in mean V′maxFRC. Infants with malacia were not more likely to worsen after β2 agonists than were infants with recurrent wheeze.

  • bronchodilation
  • infants
  • airway obstruction
  • CV, coefficient of variation
  • FRC, functional residual capacity
  • HR, heart rate
  • ILFT, infant lung function testing
  • MDI, metered dose inhaler
  • RTC, rapid thoracoabdominal compression
  • RVRTC, raised volume rapid thoracoabdominal compression
  • SaO2
  • transcutaneous oxygen saturation

https://doi.org/10.1136/adc.88.3.246

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