Trial reportPediatric pulmonology2026
Bronchodilator Responsiveness in Preterm-Born Children With Chronic Lung Disease: Importance of Individualized Testing.
Trial report in Pediatric pulmonology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
backgroundChildren born preterm with chronic lung disease of Immaturity (CLDI) frequently present with obstructive lung function, yet optimal bronchodilator therapy remains uncertain. Previous studies focused on β2-agonists, while evidence for muscarinic antagonist therapy is limited.
methodsWe conducted a prospectively planned cross-sectional study of preterm-born children (< 35 weeks) with CLDI and obstructive spirometry (FEV1 z-score < -1.64). Of 73 screened, 64 were enrolled, and 55 completed the protocol. Each attended three randomized crossover visits with salbutamol, ipratropium bromide, or fenoterol/ipratropium combination. Spirometry was performed before and after administration.
resultsOverall, 48 children demonstrated bronchodilator responsiveness to at least one agent. Response rates were 56.4% for salbutamol (95% CI 43-70), 58.2% for ipratropium (95% CI 45-71), and 65.5% for the combination (95% CI 53-78), with no significant differences (McNemar's test, p = 0.45). Exclusive responses were observed in 9.1% to salbutamol (95% CI 3.0-20.0), 5.5% to ipratropium (95% CI 1.1-15.1), and 9.1% to the combination (95% CI 3.0-20.0). Among children with reversibility, repeated-measures ANOVA showed no significant difference in the effect of drugs (F = 0.1, p = 0.9), phenotype (F = 2.46, p = 0.12), or their interaction (F = 1.1, p = 0.34).
conclusionsIn our cohort, 87% of preterm-born children with CLDI exhibit reversible bronchial obstruction, with a substantial subset responding exclusively to a single bronchodilator. Due to the fact that single-drug testing may underestimate reversibility, individualized bronchodilator testing should be incorporated into care, and its long-term implications merit further study.
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