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Influence of lung function and postnatal age on the response to nebulized ipratropium bromide in children born
1Department of Child Health, King's College Hospital, London, U.K.
Insights
Nebulized ipratropium bromide improves airway resistance in premature infants, but response varies. Higher baseline airway resistance and older postnatal age predict a better response to this treatment.
Area of Science:
- Pediatric Pulmonology
- Neonatal Medicine
- Pharmacology
Background:
- Premature infants often experience airway issues.
- Nebulized ipratropium bromide is used to treat these conditions.
- The effectiveness of ipratropium bromide can vary in this population.
Purpose of the Study:
- To investigate factors influencing ipratropium bromide response in premature infants.
- To determine if postnatal age or baseline lung function affects treatment outcomes.
Main Methods:
- Studied 45 premature infants (median gestational age 28 weeks).
- Measured airway resistance (Raw) before and after nebulized ipratropium bromide.
- Utilized whole body plethysmography for Raw measurements.
Main Results:
- 16 out of 45 infants showed significant improvement in Raw.
- Infants with higher baseline Raw had a better response.
- Postnatal age was significantly related to the change in Raw post-treatment.
Conclusions:
- Baseline lung function is a key factor in ipratropium bromide response.
- Postnatal age also influences the effectiveness of ipratropium bromide in premature infants.
- These findings aid in personalizing respiratory treatment for premature neonates.
Abstract:
Nebulized ipratropium bromide reduces airways resistance in young children born prematurely, but that response is not invariable. We have assessed whether postnatal age or baseline lung function influences the effect of ipratropium bromide. Forty-five children, median gestational age 28 weeks (range 23-34) were studied at a postnatal age of 10 months (range 6-18). Twenty-four were symptomatic at follow-up. Airways resistance (Raw) was measured using a whole body plethysmograph before (baseline) and 20 min after nebulized ipratropium bromide. Sixteen patients had a significant improvement in Raw (a reduction in Raw greater than twice the coefficient of variation of the measurement). The baseline Raw of those 16 infants was significantly higher than the baseline Raw of the other 29 infants (P < 0.01). Multiple regression analysis, after taking into account baseline lung function and symptom status, demonstrated there was a significant relationship between the change in Raw following ipratropium bromide and postnatal age (P < 0.01). We conclude that both baseline lung function and postnatal age influence the response to nebulized ipratropium bromide in young children born prematurely.