Bronchodilation in infants with malacia or recurrent wheeze

Abstract

Background: Controversy remains regarding the effectiveness of bronchodilators in wheezy infants. Aims: To assess the effect of inhaled β2 agonists on lung function in infants with malacia or recurrent wheeze, and to determine whether a negative effect of β2 agonists on forced expiratory flow (V'maxFRC) is more pronounced in infants with airway malacia, compared to infants with wheeze. Methods: We retrospectively analysed lung function data of 27 infants: eight with malacia, 19 with recurrent wheeze. Mean (SD) age was 51 (18) weeks. Mean V'maxFRC (in Z score) was assessed before and after inhalation of β2 agonists. Results: Baseline V'maxFRC was below reference values for both groups. Following inhalation of β2 agonists the mean (95% Cl) change in mean V'maxFRC in Z scores was -0.10 (-0.26 to 0.05) and -0.33 (-0.55 to -0.11) for the malacia and wheeze group, respectively. Conclusions: In infants with wheeze, inhaled β2 agonists caused a significant reduction in mean V'maxFRC. Infants with malacia were not more likely to worsen after β2 agonists than were infants with recurrent wheeze.