Study of the bronchodilating effect of three doses of nebulized oxitropium bromide in asthmatic preschool children using the forced oscillation technique.

UNLABELLED: The aim of this study was to evaluate the bronchodilating capacity of nebulized oxitropium bromide (OB) in preschool asthmatic children and to determine an appropriate dose for usage in this age group. The trial enrolled 20 patients with moderate to severe stable asthma aged between 3.2 and 6.2 years (mean 4.7). Applying a placebo controlled, double-blind design, the effect of placebo was compared with three different doses of OB (375, 750 and 1500 micrograms) and with 400 micrograms fenoterol. The three different doses of OB resulted in a highly significant bronchodilation within 15 min after administration. The observed bronchodilation was comparable between the three doses during the first 2 h. However, after 4 h the lowest dose was significantly less powerful than the highest dose. Compared to the additional bronchodilation induced by fenoterol, no difference was found with the degree of bronchodilation of OB which occurred during the first 2 h. Furthermore, after 4 h only the lowest dose of OB was significantly less powerful than fenoterol assessed 10 min following a single 400 micrograms dose. CONCLUSION: Oxitropium bromide is a potent and long-acting bronchodilator in preschool children at a dose of 750 micrograms and 1500 micrograms. No side-effects were observed. The exact duration of action remains uncertain, but even 4 h after inhaling 750 or 1500 micrograms of OB no additive bronchodilation induced by fenoterol could be observed.

Functional residual capacity in healthy preschool children.

The purpose of this study was to evaluate the feasibility of routine functional residual capacity (FRC) measurements in healthy preschool children aged 2.7-6.4 yrs. Furthermore, accuracy and reproducibility were investigated and normal values were collected. A mass-produced closed-circuit helium dilution device (rolling seal) was used. Selection of the 113 healthy children (from the 571 measured) was based on an extensive personal and family history questionnaire and on clinical examination before measurements were performed. With three successive attempts it was possible to achieve at least two reproducible measurements in 73% of the children (repeatability coefficient 95.3 mL). The main problems were leakage at the corner of the mouth and irregular breathing pattern. The mean time to perform a measurement was 113 s. Mean FRC was significantly higher in boys than in girls: 778 versus 739 mL for a body length of 110 cm (p<0.05). FRC correlated with height (H) (r=0.69), weight (W) (r=0.56), age (A) (r=0.62) and all three combined (r=0.70): FRC = -534.89 + 1.84 x W (kg) + 10.07 x H (cm) + 2.51 x A (months). When a power or exponential function was used to describe FRC as a function of height, the results were not superior to the linear regression (r=0.69): FRC (mL) = -766.2 + 13.8 x H (cm) (r=0.69) or FRC (L) = 0.620 x H (m)(2.03) (r=0.69) or FRC (mL)= 99.5 x e(0.018xH (cm)) (r=0.69). Among these, we recommend the power function because it will better fit broader height ranges. Reliable functional residual capacity measurements can be routinely performed in preschool children with a mass-produced device. Reference values were collected for children 95-125 cm in height.

Aerosolized furosemide in wheezy infants: a negative report.

We investigated the effects of 10 mg aerosolized furosemide on clinical score in 28 acutely wheezing infants (Part A) and in a second group of 20 intermittently wheezing babies on airway resistance and functional residual capacity during a symptomfree period (Part B), using a double-blind, placebo-controlled design. In both parts of the study no therapeutic effects were observed during and following aerosol inhalation of 10 mg furosemide.

Comparison of the bronchodilating effect of oxitropium bromide and fenoterol in asthmatic children.

Using a randomized double blind study design, the bronchodilating effect of 200 micrograms inhaled oxitropium bromide (OB) was compared with 200 micrograms inhaled fenoterol (F) after an interval of 20 min, in 20 asthmatic children aged 12.7 years (range: 4.9-15.1 years), suffering from mild bronchoconstriction (mean forced expiratory volume during ls: 73.4%, range: 51%-85%). Both drugs induced a comparable degree of bronchodilatation and no significant differences were found between the OB group and the F group, suggesting equipotency for both drugs after a 20 min interval, at the 200 micrograms dose level. Furthermore, a significant improvement of lung function parameters was detected in both groups after subsequent administration of 400 micrograms F, indicating that inhalation of 200 micrograms of OB or F results in submaximal bronchodilation in asthmatic children suffering from mild bronchoconstriction.