Clinical features of postinfectious bronchiolitis obliterans in children undergoing long-term nebulization treatment
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Limited data are available in relation to the clinical features of PIBO undergoing prolonged nebulization treatment with budesonide, terbutaline and ipratropium bromide. This retrospective study aimed to outline the features of clinical, high-resolution computed tomography (HRCT) and pulmonary function test (PFT) of PIBO, undergoing maintenance therapy utilizing a triple nebulization treatment and to determine the factors associated with prognosis.
Children diagnosed with PIBO were followed up between April 2014 and March 2017. The clinical features after maintenance nebulization treatment for 12 months were thereafter summarized.
Thirty patients, 21 boys and 9 girls, were enrolled in the study. The median age of patients was 17.4 months, with a range between 3.0 and 33 months. Persistent coughing and wheezing were detected whilst wheezing and crackles were the common manifestations presented. HRCT scans revealed patchy ground and glass opacity, while PFT showed fixed airway obstruction in all patients. Four patients were lost during follow-up. After treatment, the clinical symptoms were improved greatly in all patients (P < 0.01). The mean increase in the percentage of TPEF%TE and VPEF%VE were improved greatly (P < 0.01). Images of the HRCT scan indicated marked improvements in 18 patients (81.8%) in comparison with scans obtained pre-treatment.
Our data suggest a potential role of long-term nebulization treatment of budesonide, terbutaline, ipratropium bromide on PIBO, due to its efficacy as indicated in the improved clinical symptoms, pulmonary functions and CT manifestations identified in the children. New prospective and controlled studies are required to confirm this proposition.
KeywordsClinical features Nebulization treatment Post-infectious bronchiolitis obliterans Prognosis
XMZ, AZL and HWY had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. XMZ, AZL, and XBZ. conceived and designed the study. XMZ and AZL reviewed the scientific literature, did the statistical analysis, prepared all tables and figures, and wrote the first draft of the report. LLQ, LBW and XBZ reviewed and revised the article. All authors made a critical revision of the manuscript for key intellectual content.
No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
Compliance with ethical standards
This study was approved by the Hospital’s Ethics Committee, and all participants provided written consents.
Conflict of interest
The authors declare that they have no conflict of interest.
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