Background: Lung function in children with persistent asthma may be impaired during preschool and school ages. The aim of this study was to describe if some preschool impulse oscillometry (IOS) parameters are related to spirometry alterations on reaching school age.Methods: In 66 diagnosed with persistent asthma, an IOS was performed at entrance and followed-up to school age where a spirometry was done. Results:The mean age was 4.9 years at the first evaluation and 7.9 years at the second evaluation, and 59.1% were male. During preschool, R5, R20, Fres, AX, and D5−20 were found to have diagnostic accuracy (area under the curve > 0.7) for predicting abnormal spirometry during school age (defined as FEV1 and/or FEV/FVC and/or FVC values below the lower limit of normality according to Quanjer predictive values). AX, D5−20, and R5 had the best LR+ to increase the probability of abnormal spirometry (50, 10, and 7.1, respectively). R20, R5, and AX was the best IOS parameters for discriminating bronchodilator response (BDR) in schoolchildren (LR+ = 3.4, 2.9, and 2.8, respectively). Conclusion:The findings of this study indicate that some IOS parameters between 3 and 5 years of age are useful for predicting abnormal spirometry and BDR at school age.

Estudios recientes han mostrado que la terapia con moduladores de la Proteína de Conductancia de Transmembrana (CFTR) en pacientes con Fibrosis Quística (FQ) con Elexacaftor-Tezacaftor-Ivacaftor (ETI), disminuye las exacerbaciones, mejora la función pulmonar y la calidad de vida.Objetivo: reportar la respuesta clínica en la primera paciente de nuestro medio tratada con ETI.Caso Clínico: Paciente de sexo femenino de 14 años portadora de Fibrosis quística de fenotipo severo, heterocigota para la mutación Phe508del, (Phe508del/1078delT), con compromiso pulmonar moderado e insuficiencia pancreática (IP). La paciente inició terapia ETI luego de que enfermedad entró en fase de deterioro clínico y de la función pulmonar. Desde la segunda visita (45 días) y hasta el final del seguimiento (365 días) la paciente experimentó una importante mejoría en los dominios de calidad de vida medida por el cuestionario CFQ-R 14+. En el estudio de función pulmonar, a los 45 y 365 días, la CVF subió 21% y 22%, el VEF1 20% y 27%, y el FEF 25-75 en 23% y 37%, respectivamente. Los parámetros de evaluación nutricional en el primer semestre de seguimiento mostraron un aumento de pIMC de 1,6 a 5,6 k. No se observaron efectos adversos.Conclusión: el tratamiento con ETI en la paciente portadora de FQ reportada en este caso clínico, mostró una notable mejoría en calidad de vida, función pulmonar y estado nutricional.

Background: Lung function in children with persistent asthma may be impaired during preschool and school ages. The aim of this study was to describe if some preschool IOS parameters are related to spirometry alterations on reaching school age. Methods: 66 children under six years old diagnosed with persistent asthma were studied prospectively with IOS during their preschool years and spirometry at school age. Results: The mean age was 4.9 years at the first evaluation and 7.9 years at the second evaluation, and 59.1% were male. During preschool, R5, Fres, AX, and D5-20 were found to have diagnostic accuracy (AUC>0.7) for predicting altered spirometry during school age (defined as FEV1 and/or FEV/FVC and/or FVC values below the lower limit of normality according to Quanjer predictive values). AX, D5-20, and R5 had the best LR+ to increase the probability of altered spirometry (50, 10, and 7.1, respectively). R5 was the best IOS parameter for discriminating bronchodilator response (BDR) in schoolchildren (AUC=0.7, LR+ = 3.7). Abnormal IOS increases the risk of having abnormal spirometry (RR=12.7, p= 0.002). This risk is even higher in atopic patients (RR= 21, p=0.003). Conclusion: The findings of this study indicate that some IOS parameters between 3 and 5 years of age are useful for predicting abnormal spirometry and BDR at school age.