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Exercise-induced bronchoconstriction in school-aged children who had chronic lung disease in infancy

Joshi, Suchita, Powell, Tom, Watkins, William John, Drayton, Mark, Williams, E. Mark and Kotecha, Sailesh 2012. Exercise-induced bronchoconstriction in school-aged children who had chronic lung disease in infancy. The Journal of Pediatrics 162 (4) , pp. 813-818. 10.1016/j.jpeds.2012.09.040

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Abstract

Objectives: 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. Study design: 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. Conclusion: 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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Healthcare Sciences
Subjects: R Medicine > RJ Pediatrics
Uncontrolled Keywords: BPD, bronchopulmonary dysplasia, CPET, cardiopulmonary exercise testing, CLD, chronic lung disease, DLCO, lung diffusion capacity of carbon monoxide, FEV1, forced expiratory volume in 1 second, MVV, maximum voluntary ventilation, minute ventilation, carbon dioxide output, oxygen consumption
Publisher: Elsevier
ISSN: 0022-3476
Last Modified: 13 Oct 2017 22:00
URI: http://orca.cf.ac.uk/id/eprint/41223

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