title: Paradoxical response to nebulized ipratropium bromide in pre-term infants asymptomatic at follow-up.
abstract: Lung function measurements were performed before and after bronchodilator, nebulized ipratropium bromide (10 micrograms kg-1), in 20 pre-term infants [median gestational age 28 weeks (range 23-32 weeks) at a median postnatal age of 10 months (range 6-16 months)]. Eight of the infants had recurrent respiratory symptoms. Thoracic gas volume (TGV) and airways resistance (Raw) were measured by a plethysmographic technique and functional residual capacity (FRC) by a helium gas dilution technique. There was no significant change in either TGV or FRC following bronchodilator in the symptomatic and asymptomatic infants. Nebulized bronchodilator resulted in a significant improvement in Raw amongst the symptomatic infants (P less than 0.05), but a paradoxical response, that is, a deterioration (P less than 0.05) in Raw amongst the asymptomatic infants. In three asymptomatic infants, lung function measurements were repeated before and after nebulized saline and a similar deterioration in Raw was noted. We conclude the demonstration of respiratory symptoms at follow-up is useful in predicting infants who would have a beneficial response to nebulized ipratropium bromide.
authors.affiliation: Department of Child Health, King's College Hospital, London, U.K.
authors.forename: B
authors.initials: B
authors.lastname: Yuksel
authors.forename: A
authors.initials: A
authors.lastname: Greenough
authors.forename: S
authors.initials: S
authors.lastname: Green
mesh_terms: D000281:Administration, Intranasal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology; D009241:Ipratropium / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009330:Nebulizers and Vaporizers; D012120:Respiration Disorders / Q000188:drug therapy* / Q000503:physiopathology; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics / Q000187:drug effects*
chemical_list: D009241:Ipratropium