The functional response of infants with persistent wheezing to nebulized beclomethasone dipropionate.
Lung function was measured in nine infants, ages 15-36 weeks, who had persistent wheezing, apparently following acute bronchiolitis, before and after 2 weeks of treatment with either inhaled nebulized beclomethasone dipropionate (BDP) or placebo in a randomized, double blind, crossover trial. The effect of nebulized albuterol (Salbutamol) was measured before and after the steroid treatment. Thoracic gas volume (TGV) and specific airway conductance (SGaw) were determined using a whole body plethysmograph, and forced expiratory flow at resting lung volume (VmaxFRC) was determined with a thoracoabdominal compression jacket. All infants had marked airways obstruction before treatment with mean +/- SE VmaxFRC of 24 +/- 4% predicted and SGaw of 37 +/- 5% predicted. Two weeks of placebo treatment had no significant effect on lung function, but after 2 weeks of BDP inhalation there was a significant rise in SGaw to 61 +/- 7% (P less than 0.005). VmaxFRC increased to 42 +/- 13% but the difference did not reach significance. Respiratory rate and clinical score for retractions and wheezing also fell significantly with BDP therapy (P less than 0.01 and P less than 0.001 respectively). Albuterol had no effect on lung function either before or during steroid therapy. Steroids may have a role in the management of persistent wheezing following bronchiolitis.
D000281:Administration, Intranasal; D000403:Airway Resistance; D000420:Albuterol / Q000008:administration & dosage / Q000627:therapeutic use; D001507:Beclomethasone / Q000008:administration & dosage* / Q000627:therapeutic use; D001990:Bronchiolitis, Viral / Q000150:complications / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008449:Maximal Expiratory Flow-Volume Curves; D010919:Placebos; D011897:Random Allocation; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology*; D014835:Volatilization
D010919:Placebos; D001507:Beclomethasone; D000420:Albuterol