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Effect of bronchodilators on forced expiratory volume in 1 s in preterm-born participants aged 5 and over: a sytematic review

Kotecha, Sarah, Edwards, Martin, Watkins, William, Lowe, John, Henderson, A. John and Kotecha, Sailesh 2015. Effect of bronchodilators on forced expiratory volume in 1 s in preterm-born participants aged 5 and over: a sytematic review. Neonatology 107 (3) , pp. 231-240. 10.1159/000371539

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Abstract

Background and Objectives: Preterm-born participants are at risk of long-term deficits in percentage predicted forced expiratory volume in 1 s (%FEV1). Since it is unclear if these deficits respond to bronchodilators, we systematically reviewed the evidence for reversibility of deficits in %FEV1 by bronchodilators in preterm-born participants. Design: Studies reporting a change in %FEV1 in response to bronchodilator treatment in preterm-born participants at ≥5 years of age, with or without a term-born control group, were identified. The quality of studies was assessed by adapted tools. Due to considerable heterogeneity between studies, formal meta-analysis was not possible. Results: From 8,839 titles, 22 studies were identified after an updated search in May 2013. Twenty-one studies assessed the response to a single inhaled dose of a bronchodilator, and 1 study assessed longer-term effects. Most studies observed decreased %FEV1 in preterm-born participants compared with controls. Most studies observed improved %FEV1 after a single dose of bronchodilator, with the largest improvements noted in those with bronchopulmonary dysplasia, who had greater deficits of %FEV1 when compared with preterm and term controls. One long-term study investigated a 2-week terbutaline administration, but the initial FEV1 after a single dose did not show a change in %FEV1 of ≥15%, but 5/29 (17%) children had an increased %FEV1 of ≥10%. Conclusions: In this systematic review, disparate studies were identified. Although single doses of bronchodilators appear to improve the FEV1 in the short term, further studies are required to assess their longer-term benefits not only on airway obstruction, but also their effect on respiratory symptoms.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Uncontrolled Keywords: Lung spirometry, Chronic lung disease of prematurity, Bronchopulmonary dysplasia, Bronchodilator, Inhaled corticosteroids
Publisher: Karger
ISSN: 1661-7800
Date of Acceptance: 15 December 2014
Last Modified: 13 Jun 2019 09:36
URI: http://orca-mwe.cf.ac.uk/id/eprint/85801

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