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.
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.
Authors: Helly J Einisman; Benjamin Gaston; Christiaan Wijers; Laura A Smith; Tristan H Lewis; Stephen J Lewis; Thomas M Raffay Journal: Pediatr Pulmonol Date: 2019-09-04
Authors: Paul E Moore; Jason T Poston; Debra Boyer; Emily Barsky; Jonathan Gaffin; Kathleen B Boyne; Kristie R Ross; Laura Beth Mann Dosier; Timothy J Vece; Alicia M Casey; Sebastian K Welsh; J Wells Logan; Edward G Shepherd; Pelton A Phinzy; Howard B Panitch; Christina M Papantonakis; Eric D Austin; Amir B Orandi; Maleewan Kitcharoensakkul; Mark K Abe; Amjad Horani; Jordan S Rettig; Jessica Pittman Journal: Ann Am Thorac Soc Date: 2017-08
Authors: A Ioana Cristea; Clement L Ren; Reshma Amin; Laurie C Eldredge; Jonathan C Levin; Parevi P Majmudar; Anne E May; Rebecca S Rose; Michael C Tracy; Karen F Watters; Julian Allen; Eric D Austin; Mary E Cataletto; Joseph M Collaco; Robert J Fleck; Andrew Gelfand; Don Hayes; Marcus H Jones; Sheila S Kun; Erica W Mandell; Sharon A McGrath-Morrow; Howard B Panitch; Rizwana Popatia; Lawrence M Rhein; Alejandro Teper; Jason C Woods; Narayan Iyer; Christopher D Baker Journal: Am J Respir Crit Care Med Date: 2021-12-15 Impact factor: 21.405
Authors: Martin O Edwards; Sarah J Kotecha; John Lowe; Louise Richards; W John Watkins; Sailesh Kotecha Journal: PLoS One Date: 2016-05-20 Impact factor: 3.240
Authors: Sarah J Kotecha; W John Watkins; John Lowe; Raquel Granell; A John Henderson; Sailesh Kotecha Journal: Am J Epidemiol Date: 2019-03-01 Impact factor: 4.897