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

Neonatology. 2015;107(3):231-40. doi: 10.1159/000371539.

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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Bronchodilator Agents / administration & dosage*
  • Bronchopulmonary Dysplasia / drug therapy*
  • Child
  • Child, Preschool
  • Forced Expiratory Volume / drug effects
  • Humans
  • Premature Birth
  • Spirometry
  • Treatment Outcome
  • Young Adult

Substances

  • Bronchodilator Agents