Bronchodilator responsiveness using spirometry in healthy and asthmatic preschool children

Abstract

BDR can be assessed reliably using FEV(0.75) in wheezy preschoolers, provided within-subject variability and responsiveness in health are taken into consideration.

Forced expiratory flows’ contribution to lung function interpretation in schoolchildren

“…Our study included younger children and no data are available on the possible change in FEF reversibility with age in healthy children. In healthy preschool aged children the mean+1.96SD BDR change in FEF25-75% was 47.8%, very close to our findings in healthy, young school children [13].…”

“…We did not administer placebo in order to assess the short-term biological and instrumental variability. In a study conducted in preschool aged children [13], healthy children had narrower limits of agreement in post-placebo changes than in post-BD changes (i.e. upper limits of FEV1 +14% versus +18%, and of FEF25-75% +33% versus +47.8%, respectively).…”

“…Moreover, clinical implications for FEF have been claimed, such as optimising the diagnosis of bronchial hyperreactivity when used as a co-criterion to FEV1 decrease [8], or predicting significant bronchodilation [9]. Consequently, and despite recent considerations on the lack of clinical utility of baseline FEF to detect bronchial obstruction [10], physicians who routinely take care of asthmatic children are prone to scrutinise FEF, looking for baseline small-airways obstruction [11], or for significant FEF improvement (without FEV1 improvement) after asthma-controller treatment [12] or acute bronchodilation [13]. However, the relevant threshold to assess FEF reversibility has not been validated.…”

The Importance Of Learning Effect In The Assessment Of The Reversibility Measurement By Pulmonary Function Test

“…sonar yapılan solunum fonksiyon testinde sağlıklı çocuklarda bir fark olmadığını gözlemledi (10) . Bu çalışmada bizim çalışmamızdan farklı olarak çalışma grubunu çocuk-lar oluşturmakta olmasına rağmen, öğrenme etkisinin görülmemesi ilginçtir.…”

Special considerations—asthma in children

“…34 The information gleaned from the lung mechanics at baseline may be further enhanced with spirometry performed pre-bronchodilator and post-bronchodilator administration. 35,36 Bronchodilators include B2-agonists that dilate smooth muscles and provide diagnostic insight into the reversibility of airway bronchoconstriction. Data is interpreted based on predicted pediatric values that rely on age, gender, height, and ethnic background.…”