Bronchial reactivity in infants in acute respiratory failure with viral bronchiolitis
Autor: | Nakayama Dk, Anastassios C. Koumbourlis, Mutich Rl, Etsuro K. Motoyama, George B. Mallory |
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Rok vydání: | 1989 |
Předmět: |
Male
Pulmonary and Respiratory Medicine Vital capacity medicine.drug_class medicine.medical_treatment Air trapping Respirovirus Infections FEV1/FVC ratio Bronchodilator Isoetharine Bronchiolitis Viral Humans Medicine Prospective Studies Mechanical ventilation business.industry Infant Newborn Infant respiratory system Airway obstruction medicine.disease Respiratory failure Bronchiolitis Child Preschool Anesthesia Acute Disease Pediatrics Perinatology and Child Health Female medicine.symptom Pulmonary Ventilation Respiratory Insufficiency business |
Zdroj: | Pediatric Pulmonology. 6:253-259 |
ISSN: | 1099-0496 8755-6863 |
Popis: | Airway reactivity and the effects of bronchodilators in infants are controversial. We studied the response to bronchodilator treatment in 14 mechanically ventilated infants (mean age, 2.74 months; range, 0.6-5.9) in respiratory failure caused by respiratory syncytial virus (RSV)-associated bronchiolitis. Sixteen infants without lung disease, undergoing elective surgery, provided normal values. Maximum expiratory deflation flow-volume (DFV) curves were produced by manual inflation of the lungs with an anesthesia bag to a predetermined static airway pressure followed by rapid deflation with a negative airway pressure before and after administration of bronchodilator. At baseline, the bronchiolitis group had a forced vital capacity (FVC) of 34.5 +/- 3.6 ml/kg compared with 41.8 +/- 1.5 ml/kg in the normal group; maximum expiratory flow rate at 25% of FVC (MEF25) was 10.2 +/- 2.0 ml/kg/s compared with 27.3 +/- 2.0 ml/kg/s in the normal group. The clinical and radiologic impression was severe lower airway obstruction and air trapping. After administration of bronchodilator, FVC did not increase significantly, but MEF25isov increased by over 30% in 13 of 14 infants. Mean MEF25 increased by 148 +/- 43.2% to 21.7 +/- 3.9 ml/kg/s (P less than 0.02). These findings indicate that during the acute phase of severe RSV-positive bronchiolitis most infants have airway reactivity that responds positively to bronchodilator treatment. |
Databáze: | OpenAIRE |
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