Paradoxical response to nebulized ipratropium bromide in pre-term infants asymptomatic at follow-up

Respir Med. 1991 May;85(3):189-94. doi: 10.1016/s0954-6111(06)80078-8.

Abstract

Lung function measurements were performed before and after bronchodilator, nebulized ipratropium bromide (10 micrograms kg-1), in 20 pre-term infants [median gestational age 28 weeks (range 23-32 weeks) at a median postnatal age of 10 months (range 6-16 months)]. Eight of the infants had recurrent respiratory symptoms. Thoracic gas volume (TGV) and airways resistance (Raw) were measured by a plethysmographic technique and functional residual capacity (FRC) by a helium gas dilution technique. There was no significant change in either TGV or FRC following bronchodilator in the symptomatic and asymptomatic infants. Nebulized bronchodilator resulted in a significant improvement in Raw amongst the symptomatic infants (P less than 0.05), but a paradoxical response, that is, a deterioration (P less than 0.05) in Raw amongst the asymptomatic infants. In three asymptomatic infants, lung function measurements were repeated before and after nebulized saline and a similar deterioration in Raw was noted. We conclude the demonstration of respiratory symptoms at follow-up is useful in predicting infants who would have a beneficial response to nebulized ipratropium bromide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / physiopathology
  • Ipratropium / administration & dosage
  • Ipratropium / therapeutic use*
  • Male
  • Nebulizers and Vaporizers
  • Respiration Disorders / drug therapy*
  • Respiration Disorders / physiopathology
  • Respiratory Function Tests
  • Respiratory Mechanics / drug effects*

Substances

  • Ipratropium