Metaproterenol in children with chronic asthma.

Metaproterenol sulfate was given to 25 children with asthma in the form of a syrup in a continuous treatment course of 180 days. Dosage amounted to 10 to 20 mg metaproterenol four times daily, depending on the patient's age and weight. Double-blind crossover tests of pulmonary function were run against placebo at the beginning and after 3 and 6 mo of treatment. The peak expiratory flow rate responses to metaproterenol consistently exceeded the responses to placebo, the differences proving statistically significant at several intervals after administration. Adverse reactions were limited to instances of hyperactivity in one child and of mild tremors in another; laboratory values remained normal throughout the 6-mo period except for low normal fasting blood sugar values recorded in 2 patients at the end of the study. Pulse rate increases occurring after metaproterenol were not considered clinically important.

Technetium Tc 99m macroaggregated albumin lung scans. Use in chronic childhood asthma.

Serial roentgenograms and technetium Tc 99m macroaggregated albumin lung scans were done simultaneously in 30 bronchodilator-dependent asthmatic children and young adults during both relative remission and attacks of status asthmaticus. When chest roentgenograms showed air trapping and increased peribronchial vascular marking associated with persistent perfusion defects, the children benefited from further laboratory studies and continuous comprehensive therapy. Serial scans provided information about underperfusion that was not discernible either by roentgenograms or by usual blood gas studies. Also, lung scans are easier to obtain in children with long-standing asthma than are detailed pulmonary tests. In our study, technetium Tc 99m macroaggregated albumin scans showed persistent regional perfusion defects in 20 children wiht chronic asthma during relative remission and exacerbations.