title: Exercise-induced bronchoconstriction in school-aged children who had chronic lung disease in infancy.
abstract: OBJECTIVE
  To assess for exercise-induced bronchoconstriction in 8- to 12-year-old children who had chronic lung disease (CLD) in infancy, and to evaluate the response of bronchoconstriction to bronchodilation with albuterol in comparison with preterm and term controls.
  
  
  METHODS
  Ninety-two children, including 29 with CLD, 33 born preterm at ≤32 weeks' gestation, and 30 born at term, underwent lung spirometry before and after cycle ergometry testing and after postexercise bronchodilation with albuterol.
  
  
  RESULTS
  Doctor-diagnosed asthma and exercise-induced wheeze were reported more frequently in the CLD group than in the preterm and term groups, but only 10% were receiving a bronchodilator. There were no differences among the groups in peak minute ventilation, oxygen uptake, or carbon dioxide output at maximum exercise. After maximal exercise, predicted forced expiratory volume in 1 second (FEV1) decreased from a mean baseline value of 81.9% (95% CI, 76.6-87.0%) to 70.8% (95% CI, 65.5-76.1%) after exercise in the CLD group, from 92.0% (95% CI, 87.2-96.8%) to 84.3% (95% CI, 79.1-89.4%) in the preterm group, and from 97.5% (95% CI, 92.5-102.6%) to 90.3% (95% CI, 85.1-95.5%) in the term group. After albuterol administration, FEV1 increased to 86.8% (95% CI, 81.7-92.0%) in the CLD group, 92.1% (95% CI, 87.3-96.9%) in the preterm group, and 97.1% (95% CI, 92.0-102.3%) in the term group. The decrease in predicted FEV1 after exercise and increase in predicted FEV1 after bronchodilator use were greatest in the CLD group (-11.0% [95% CI, -18.4 to -3.6%] and 16.0% [95% CI, 8.6-23.4%], respectively; P < .005 for both), with differences of <8% in the 2 control groups.
  
  
  CONCLUSIONS
  School-age children who had CLD in infancy had significant exercise-induced bronchoconstriction that responded significantly to bronchodilation. Reversible exercise-induced bronchoconstriction is common in children who experienced CLD in infancy and should be actively assessed for and treated.
authors.affiliation: Department of Child Health, School of Medicine, Cardiff University, Cardiff, United Kingdom.
authors.forename: Suchita
authors.initials: S
authors.lastname: Joshi
authors.forename: Thomas
authors.initials: T
authors.lastname: Powell
authors.forename: William J
authors.initials: WJ
authors.lastname: Watkins
authors.forename: Mark
authors.initials: M
authors.lastname: Drayton
authors.forename: E Mark
authors.initials: EM
authors.lastname: Williams
authors.forename: Sailesh
authors.initials: S
authors.lastname: Kotecha
mesh_terms: D000420:Albuterol / Q000627:therapeutic use; D001250:Asthma, Exercise-Induced / Q000188:drug therapy; D016084:Bronchoconstriction / Q000187:drug effects*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D015444:Exercise; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008168:Lung / Q000473:pathology; D008171:Lung Diseases / Q000150:complications / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D013147:Spirometry / Q000379:methods
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol