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Nebulised sodium cromoglycate in infancy: airway protection after deterioration
C O'Callaghan1, A D Milner, A Swarbrick
1Department of Child Health, University Hospital, Queen's Medical Centre, Nottingham.
Insights
Nebulized water can trigger bronchoconstriction in infants with wheeze. While sodium cromoglycate initially worsened lung function, it ultimately protected airways from water-induced challenges.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Allergy and Immunology
Background:
- Infants with a history of wheeze are susceptible to airway hyperresponsiveness.
- Nebulized water challenges are used to assess airway reactivity in infants.
Purpose of the Study:
- To investigate the effect of nebulized water on lung function in infants with a history of wheeze.
- To evaluate the protective role of sodium cromoglycate against nebulized water-induced bronchoconstriction.
Main Methods:
- 100 infants with wheeze histories underwent nebulized water challenges.
- Lung function was measured using total body plethysmography.
- Sodium cromoglycate was administered to a subset of infants who developed bronchoconstriction.
Main Results:
- Nebulized water challenge led to significant bronchoconstriction in susceptible infants.
- Sodium cromoglycate initially caused a decrease in specific conductance.
- Subsequent nebulized water challenge after sodium cromoglycate showed no further lung function deterioration, indicating protection.
Conclusions:
- Nebulized water can be a potent trigger for bronchoconstriction in infants with a history of wheeze.
- Sodium cromoglycate, despite initial adverse effects on lung function, demonstrated a protective effect against nebulized water challenges in this cohort.
Abstract:
Over a two year period 100 infants with histories of wheeze were challenged with nebulised water. They were sedated and lung function measured by total body plethysmography. Thirteen of the 53 infants who developed bronchoconstriction after challenge with nebulised water were given nebulised sodium cromoglycate and rechallenged with nebulised water. All infants were initially challenged with normal saline, after which there was no significant change in lung function. After challenge with nebulised water and sodium cromoglycate there were significant decreases in specific conductance compared with those found after challenge with normal saline. After rechallenge with nebulised water there was no deterioration in lung function. Although sodium cromoglycate caused a deterioration in lung function in these infants, it protected their airways from challenge with nebulised water.