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% CI) 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.