The protective effect of a single dose salbutamol against exercise induced inspiratory airflow limitation in asthmatic children: a randomized double-blind placebo-controlled cross-over intervention study.

Graaf, B.J. de (2014) The protective effect of a single dose salbutamol against exercise induced inspiratory airflow limitation in asthmatic children: a randomized double-blind placebo-controlled cross-over intervention study. thesis, Medicine.

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Abstract

Background: Exercise can lead to an expiratory and an inspiratory airflow limitation in asthmatic children. Salbutamol offers excellent protection against exercise induced expiratory airflow limitation (EIEAL). The aim of this study is to investigate the protective effect of salbutamol against exercise induced inspiratory airflow limitation (EIIAL) in asthmatic children. Methods: 47 asthmatic children (aged 8-16 years) performed a baseline exercise challenge test (ECT) in cold and dry air on a treadmill or jumping castle. A fall of ≥ 25% of maximal inspiratory airflow at 50% of vital capacity (MIF50) was the threshold for an inspiratory airflow limitation. A fall of ≥13% of forced expiratory volume in 1 second (FEV1) was the threshold for expiratory airflow limitation. Children with an EIIAL received placebo or 200μg salbutamol in a double-blind design and in a randomized order, 15 minutes prior to the second and third ECT. Results: 15 children showed an EIIAL, but 2 children were excluded for analysis. Of the remaining 13 children, 8 showed a combined fall in MIF50 and FEV1 and 5 showed an isolated fall in MIF50. Mean exercise induced fall in MIF50 was significantly less with salbutamol 17.7% (± 13.2%) compared to 28.2% (± 11.8%) with placebo (95% CI 2.0 - 18.9%; p= 0.026). Salbutamol offered a good protection against EIIAL in 6 children. No correlation was found between the protective effect of salbutamol against fall in MIF50 and FEV1 (Spearman‘s rho 0,381; p= 0.352). Interpretation: This study shows that a single dose salbutamol prior to exercise can reduce EIIAL in asthmatic children. However, there is a great individual variability in the protective effect of salbutamol to EIIAL. Clinicians should be aware that children who have persistent exercise induced asthma-like symptoms despite the use of prophylactic salbutamol, can suffer from an salbutamol resistant inspiratory airflow limitation as an element of their asthma.

Item Type:	Thesis (Thesis)
Supervisor name:	Thio, Dr. B.J.
Supervisor name:	Visser, Mw. R. and Medisch Spectrum Twente
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:51
Last Modified:	25 Jun 2020 10:51
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1219

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