Annals of allergy
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Clinical Trial Controlled Clinical Trial
Assessment of response to oral metaproterenol sulfate by forced oscillation in young children.
The dose response characteristics and side effects of three doses of oral metaproterenol sulfate (MS) (0.4, 0.6, and 0.8 mg/kg) were compared with a placebo in ten asthmatic children (3 to 6 years). The bronchodilator efficacy was objectively assessed by evaluating the decrease in mean total respiratory resistance (MTRR) using Oscillaire. The mean percentage changes from baseline in MTRR showed that MS in all three doses was more effective than placebo. ⋯ Until recently, it was not possible to objectively measure the response to bronchodilators in children below 6 years of age because of their inability to reliably perform forced expiratory maneuvers required for spirometry and their unwillingness to have airway resistance (or conductance) measurements by body plethysmography. Direct measurements of airflow resistance have been made in children with a pneumotachograph at the mouth and a balloon in the esophagus to record transpleural pressure changes; however, these techniques are invasive and require sedation. Total respiratory resistance and reactance of the respiratory system, as measured by forced oscillation technique, are pulmonary function tests that can be performed in young children who are unable to cooperate with conventional spirometric maneuvers.
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Continuous terbutaline nebulization for the treatment of severe exacerbations of asthma in children.
Twelve children with severe asthma were treated in an intensive care unit with continuously nebulized terbutaline at doses between 1.0 and 12.0 mg/hour. All patients showed improvement in blood gases, pulse, and respiratory rates. ⋯ The duration of therapy ranged from 1 to 24 hours (mean = 8.3 hours), and all were able to leave the intensive care unit within one day. The use of continuously nebulized terbutaline appears to be safe and effective for the treatment of severe asthma in children in this limited experience.
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An anaphylactic reaction to a hair dye is reported. Skin testing with the dye and its individual components demonstrated a wheal and flare response to an oxidation product of p-phenylenediamine. This product is N'N'-bis-(4-aminophenyl)-2,5-diamino-1,4-quinonediimine. Passive transfer of this sensitivity by the patient's serum to a normal control implicated an IgE-mediated reaction.