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Bronchial reactivity in infants in acute respiratory failure with viral bronchiolitis
Author(s) -
Koumbourlis Anastassios C.,
Mutich Rebecca L.,
Motoyama Etsuro K.,
Mallory George B.,
Nakayama Don K.
Publication year - 1989
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950060408
Subject(s) - medicine , bronchodilator , bronchiolitis , anesthesia , vital capacity , airway , air trapping , airway obstruction , lung volumes , respiratory system , lung , asthma , diffusing capacity , lung function
Airway reactivity and the effects of bronchodilators in infants are controversial. We studied the response to bronchodilator treatment in 14 mechanically ventilated infants (mean age, 2.74 months; range, 0.6–5.9) in respiratory failure caused by respiratory syncytial virus (RSV)‐associated bronchiolitis. Sixteen infants without lung disease, undergoing elective surgery, provided normal values. Maximum expiratory deflation flow‐volume (DFV) curves were produced by manual inflation of the lungs with an anesthesia bag to a predetermined static airway pressure followed by rapid deflation with a negative airway pressure before and after administration of bronchodilator. At baseline, the bronchiolitis group had a forced vital capacity (FVC) of 34.5 ± 3.6 ml/kg compared with 41.8 ± 1.5 ml/kg in the normal group; maximum expiratory flow rate at 25% of FVC (MEF 25 ) was 10.2 ± 2.0 ml/kg/s compared with 27.3 ± 2.0 ml/kg/s in the normal group. The clinical and radiologic impression was severe lower airway obstruction and air trapping. After administration of bronchodilator, FVC did not increase significantly, but MEF 25 isov increased by over 30% in 13 of 14 infants. Mean MEF 25 increased by 148 ± 43.2% to 21.7 ± 3.9 ml/kg/s ( P < 0.01). These findings indicate that during the acute phase of severe RSV‐positive bronchiolitis most infants have airway reactivity that responds positively to bronchodilator treatment.