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Abstract
We investigated the effect of inhaled glucocorticoid (GC) on bronchial obstruction and on bronchial lability in schoolchildren born preterm.
Twenty-one children with bronchial obstruction, increased responsiveness to aβ2 -agonist, and/or increased diurnal variation in peak expiratory flow (PEF) were selected for an open longitudinal study of the value of inhaled GC. None of these children had an earlier diagnosis of asthma or current GC treatment. Eighteen children with median (range) birth weight 1025 (640–1600) g and gestational age 28 (24–35) weeks, age at study 10·1 (7·7–13) years, were treated with inhaled budesonide in initially high (0·8 mg m−2day−1for 1 month) and subsequently lower dose (0·4 mg m−2day−1for 3 months). Daily symptom scores were recorded. Spirometric values were measured in the clinic at the beginning and end of each treatment period. At home, children used a data storage spirometer.
After treatment with budesonide for 4 months, spirometric values in the clinic did not significantly change. The median forced expiratory volume in 1 sec (FEV1) was 74% of predicted both at entry and after budesonide treatment. However, the median number of ≥20% diurnal change in PEF values at home decreased during treatment.
According to the present study, inhaled budesonide for 4 months had no significant effect on basic lung function but may decrease bronchial lability in schoolchildren born preterm.
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References
References
- Bronchial responsiveness to histamine: relationship to diurnal variation of peak flow rate, improvement after bronchodilator, and airway calibre.Thorax. 1982; 37: 423-429
- Late pulmonary sequelae of bronchopulmonary dysplasia.N Engl J Med. 1990; 323: 1793-1799
- Clinical significance of airway responsiveness in children of low birthweight.Pediatr Pulmonol. 1989; 7: 251-258
- Bronchial lability and responsiveness in schoolchildren born very preterm.Am J Respir Crit Care Med. 1997; 156: 1178-1184
- Eosinophilic inflammation in asthma.N Engl J Med. 1990; 323: 1033-1039
- Comparison of a β2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma.N Engl J Med. 1991; 325: 388-392
- Effects of 22 months treatment with inhaled corticosteroid and/or β2-agonist on lung function, airway responsiveness, and symptoms in children with asthma.Am Rev Respir Dis. 1992; 146: 547-554
- Morphometric analysis of the lung in BPD.Am Rev Respir Dis. 1991; 143: 391-400
- The role of inflammation in the pathogenesis of bronchopulmonary dysplasia.Pediatr Pulmonol. 1995; 19: 371-378
- Bronchopulmonary dysplasia: early diagnosis, prophylaxis, and treatment.Arch Dis Child. 1990; 65: 1082-1088
- Randomised trial of inhaled steroids in preterm infants with respiratory symptoms at follow up.Thorax. 1992; 47: 910-913
- Increased airway responsiveness in children of low birth weight at school age: effect of topical corticosteroids.Arch Dis Child. 1993; 63: 120-124
- Effect of neonatal surfactant therapy on lung function at school age in children born very preterm.Pediatr Pulmonol. 1998; 25: 182-190
- Pulmonary Function Testing in Children: Technics and Standards. W.B. Saunders, 1971
- Am Rev Respir Dis. 1991; 144: 1202-1218
- Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate.Thorax. 1980; 35: 732-738
- Abnormal pulmonary outcomes in premature infants: Prediction from oxygen requirement in the neonatal period.Pediatrics. 1988; 82: 527-532
- Am Rev Respir Dis. 1995; 152: 1107-1136
- Influence of inspiratory flow rate upon the effect of a Turbuhaler.Arch Dis Child. 1990; 65: 308-319
- Long-term pulmonary sequelae of severe bronchopulmonary dysplasia.J Pediatr. 1998; 133: 193-200
- Bronchial hyperreactivity in healthy lung long term after conventional mechanical ventilation (CMV).Eur Respir J. 1999; 14: A2086
- Effect of long-term treatment with inhaled corticosteroids and beta-agonists on the bronchial responsiveness in children with asthma.J Allergy Clin Immunol. 1987; 79: 653-659
- Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma.N Engl J Med. 1994; 331: 700-705
- Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children.Respir Med. 1994; 88: 373-381
- Budesonide treatment of moderate and severe asthma in children: a dose-response study.J Allergy Clin Immunol. 1995; 95: 29-33
- The Childhood Asthma Management Program (CAMP) Research Group. Relationships between duration of asthma and asthma severity among children in the Childhood Asthma Management Program (CAMP).J Allergy Clin lmmunolgy. 1999; 103: 376-387
- Peripheral blood lymphocyte subpopulations in schoolchildren born very preterm.Arch Dis Child Fetal Neonatal Ed. 1999; 81: F188-F193
- A comparison of beclomethasone, salmeterol, and placebo in children with asthma.N Engl J Med. 1997; 337: 1659-1665
- Montelukast for chronic asthma in 6- to 14-year old children: a randomized, double-blind trial.JAMA. 1998; 279: 1181-1186
Article info
Publication history
Accepted:
March 9,
2001
Received:
June 30,
2000
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© 2001 Harcourt Publishers Ltd. Published by Elsevier Inc.
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