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Bronchodilator responsiveness in cystic fibrosis children treated for pulmonary exacerbations

Mordechai Pollak1, Michelle Shaw2,3, David Wilson1

  • 1Division of Respiratory Medicine, Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Pediatric Pulmonology
|April 8, 2021
PubMed

Insights

Bronchodilator response testing during cystic fibrosis pulmonary exacerbations is rarely significant and does not predict lung function recovery. Routine testing for bronchodilator response is not indicated during these events.

Area of Science:

  • Pulmonology
  • Pediatric Medicine
  • Respiratory Medicine

Background:

  • Cystic fibrosis (CF) pulmonary exacerbations (PEx) significantly impair lung function.
  • The utility of bronchodilator (BD) responsiveness testing during PEx treatment to monitor recovery is uncertain.

Purpose of the Study:

  • To evaluate the clinical value of measuring bronchodilator responsiveness during PEx treatment in pediatric CF patients.
  • To determine if BD response during PEx correlates with baseline lung function or predicts recovery.

Main Methods:

  • Retrospective analysis of spirometry with BD testing during hospital admissions for PEx in pediatric CF patients.
  • Included repeated events for patients with multiple admissions.

Main Results:

  • 249 spirometries with BD testing in 102 patients were analyzed around Day 7 of admission.
  • BD response around Day 7 showed poor correlation with pre-PEx FEV1 and no correlation with end-of-treatment FEV1 recovery.
  • Only 9% of tests showed a significant BD response (≥12% and 200 ml increase in FEV1).

Conclusions:

  • Significant bronchodilator response is uncommon in CF patients during PEx treatment.
  • BD response during PEx does not correlate with baseline pulmonary function or predict FEV1 recovery.
  • Routine BD response testing is not indicated during CF pulmonary exacerbations.
Abstract

Keywords:
cystic fibrosis (CF)evidence-based medicine and outcomespulmonary function testing (PFT)

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