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The response to beta-agonists in wheezy infants: three methods compared
Caroline S Beardsmore1, Catherine Page, Michael Silverman
1Department of Child Health, Institute for Lung Health, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, P.O. Box 65, Leicester LE2 7LX, UK. csb@le.ac.uk
Respiratory Medicine
|November 6, 2004
Summary
Salbutamol did not consistently improve wheezing in infants when assessed by forced expiration. Respiratory mechanics measures showed no significant changes, suggesting alternative assessment methods may be better.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Conflicting results exist regarding salbutamol's effectiveness for infantile wheeze.
- Differences in outcome variables may explain inconsistent findings.
Purpose of the Study:
- To evaluate salbutamol's effect on infantile wheeze using passive and forced expiration indices.
- To assess bronchodilator response in infants with wheezing history.
Main Methods:
- Recruited 39 infants with wheezing history (mean age 43 weeks).
- Measured maximal flow at functional residual capacity (V'(max FRC)) and forced expired volume at 0.4s (FEV0.4).
- Assessed passive compliance (C(rs)), resistance (R(rs)), and time constant (tau) before and after salbutamol inhalation.
Main Results:
- No significant mean changes in forced expiration indices (V'(max FRC), FEV0.4) post-salbutamol.
- Some infants showed individual improvements or worsening in specific indices.
- A small increase in passive compliance (C(rs)) was observed, but resistance (R(rs)) and time constant (tau) remained unchanged.
Conclusions:
- No consistent bronchodilator response to salbutamol was observed in forced expiration indices.
- Respiratory mechanics may not be the most reliable method for assessing salbutamol response in this population.
- Validated clinical scores or alternative physiological techniques are recommended for evaluating bronchodilator response.
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