Prevalence of paradoxical bronchoconstriction after inhaled albuterol.

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Prevalence of paradoxical bronchoconstriction after inhaled albuterol.

Respir Med. 2018 Aug;141:100-102

Authors: Schissler AJ, Celli BR

Abstract
PURPOSE: Paradoxical bronchoconstriction with resulting decreased airflow occurs in some patients after administration of bronchodilators. This study assessed the frequency of paradoxical bronchoconstriction in a real-life clinical setting at a large academic medical center.
PROCEDURES: We analyzed data from 4593 patients who underwent pre- and post-bronchodilator spirometry testing. We assessed the forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) before and after the administration of an inhaled short-acting β2-agonist. Patients were categorized into 3 groups: bronchodilation, no significant change and paradoxical bronchoconstriction.
MAIN FINDINGS: When assessing response to bronchodilators, 201 (4.4%) patients demonstrated significant bronchoconstriction, whereas 849 (18.5%) showed bronchodilation. The majority (3543 or 77.1%) had no significant change. There were no significant relationships noted between paradoxical bronchoconstriction and sex, race/ethnicity or body mass index.
CONCLUSIONS: A significant subset of patients experience paradoxical bronchoconstriction after albuterol administration. Further research to better understand the clinical implications of paradoxical acute bronchoconstriction is needed.

PMID: 30053954 [PubMed - in process]

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