Abstract

ESTOL HAYWARD, PAUL; CAPANO, ANíBAL; SARACHAGA, MARíA JULIA  and  BREA, SILVIA. Broncodilatación en niños preescolares: fenoterol comparado con la asociación de fenoterol y bromuro de ipratropium.: Efectos sobre la mecánica pulmonar. Arch. Pediatr. Urug. [online]. 2004, vol.75, n.3, pp.212-219. ISSN 0004-0584.

Summary In previous non controlled data, we observed an increased frequency of paradoxical responses when Fenoterol (F) was administered to children < 6 years age as compared to a combination of fenoterol and ipratropium B (BF). Objectives: to compare the spirometric response to BF as compared to F in this age group. Methods: children 0-5 years referred for respiratory function determination due to a preceding bronchial obstruction, which presented with inspiratory airway resistance (Ri)= > than p90 of normal range as determined by dynamic spirometry. In each case, F (fenoterol 400 µg), or BF (ipratropium 80 µg + fenoterol 200 µg was administered in a randomized fashion, with a spacer provided with a face mask. Ten minutes later, a second Ri determination was performed. A positive response was considered when Ri decreased as compared to basal study (Student test), paradoxical response was considered when a significant increase of the Ri was evidenced. In function of our previous data, an alpha value = 0,05 and a beta value = 0,20, n was estimated in 232 children for each treatment group. Results: 472 patients were studied, 232 in BF group and 240 in F group. No relevant significant differences were observed in group composition. Group BF evidenced a positive response in 65,9% of the cases and group F in 62,9% (ns). Group B evidenced 9,9% of paradoxical response whereas group F 11,7% (ns). The only significant difference was a greater increase in heart rate in group F (+21,8%) as compared to group BF (+13,7%) (T=5,83 p<0,0001). Conclusions: no differences were evidenced in immediate bronchodilator response to BF or F in children less than 6 years as assessed by dynamic spirometry.

Keywords : ASTHMA-drug therapy; BRONCHODILATOR AGENTS      -therapeutic use; RESPIRATORY FUNCTION TESTS; AIRWAY RESISTANCE.

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