Prendiville A, Green S, Silverman M
Department of Paediatrics and Neonatal Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Thorax. 1987 Feb;42(2):86-91. doi: 10.1136/thx.42.2.86.
Lower airway responses to nebulised bronchodilators were studied in 18 chronically or recurrently wheezy infants, aged 3-15 months, by means of partial forced expiratory flow-volume manoeuvres performed with an inflatable jacket. Maximum flow at functional residual capacity (FRC) (VmaxFRC) was used as the index of intrathoracic airways function. Peak expiratory flow rate was also measured. Baseline airways resistance and lung volume were determined during quiet breathing in an infant whole body plethysmograph. Measurements were made on separate days before and after nebulised salbutamol 2.5 mg with nebulised saline as control. The results were paradoxical: there was no change in VmaxFRC after saline, but a significant decline in VmaxFRC was found after salbutamol. Peak expiratory flow remained unchanged. These observations suggest that under conditions of forced expiration intrathoracic airways function may be further impaired by nebulised bronchodilator treatment in wheezy infants. When nebulised bronchodilator drugs are used to treat severe airways obstruction in infancy, careful monitoring is essential.
通过使用充气夹克进行部分用力呼气流量容积操作，对18名3至15个月大的慢性或反复喘息婴儿的下呼吸道对雾化支气管扩张剂的反应进行了研究。功能残气量（FRC）时的最大流量（VmaxFRC）用作胸内气道功能指标。还测量了呼气峰值流速。在婴儿全身体积描记器中安静呼吸时测定基线气道阻力和肺容积。在不同日期分别在雾化2.5毫克沙丁胺醇之前和之后进行测量，以雾化生理盐水作为对照。结果自相矛盾：生理盐水后VmaxFRC无变化，但沙丁胺醇后VmaxFRC显著下降。呼气峰值流速保持不变。这些观察结果表明，在用力呼气的情况下，雾化支气管扩张剂治疗可能会进一步损害喘息婴儿的胸内气道功能。当使用雾化支气管扩张剂药物治疗婴儿严重气道阻塞时，仔细监测至关重要。
