Inhalative bronchiale Provokationstests bei Kindern: Vergleichende Messungen der Oszillations-, Verschlußdruck- und plethysmographischen Resistance

Abstract

Examination of the lung function and bronchial provocation tests are useful for confirmation of an airway obstruction. There is a need for measurements independent of child cooperation. The standard method is body plethysmography. Forced oscillation method and interrupted occlusion method were recently introduced. Measurements of airway resistance by body plethysmography (Raw), by forced oscillation (Ros) and by interrupted occlusion method (Rvd) were compared during 78 inhalative bronchial provocation tests. The correlation index between Raw and Ros total was 0,84 and between Raw and Rvd 0,89. There is a good sensitivity and specifity in allergen bronchial provocation testing in all three methods. A bronchial sensitivity is confirmed in body plethysmography by 100% increase of Raw. In the interrupted method a 50% increase of Rvd in children smaller than 165 cm and in forced oscillation method a relative increase of 25% (0,15 kPa/l/s) is sufficient to assess a bronchial sensitivity to tested allergen.

Reproducibility of responsiveness to a standardized bronchial allergen provocation—Rt compared to FEV1 as measurement of response to provocation

“…Determination of totat resistance to breathing (Ri). This was performed by the opening interrupter method [9][10][11] (APTA, Eric Jaeger Gmbh, Wurzburg, FRG) before measurement of FEV]. The APTA (now Bronchoscreen) has a combined provocation measuring head.…”

Überempfindliche Atemwege im Kindesalter

“…Die Bodyplethysmographie ist nicht ohne Belastung für den Patienten, erfordert jedoch nur eine geringe Mitarbeit. Die Oszillationsmethode und die Verschlußdruckmethode sind zwar nicht belastend und nicht mitarbeitsabhängig, jedoch nicht ausreichend empfindlich(8,63,73,115). Durch die Spirometrie kann das Bronchialsystem selbst beeinflußt werden (Spirometerasthma)(82,86).…”

The forced oscillation technique in children with respiratory disease

“…Although the effective resistance (Rrs) and the effective reactance (XrJ are not equivalent to or readily interpretable in terms of established pulmonary parameters, several reports have indicated the usefulness of the technique in monitoring short-term changes in the bronchial status. [1][2][3][4] Experience with the technique in other pathologic conditions, however, is limited. 5 Grimby et a1.6 reported a marked negative frequency dependence of R, in obstructive lung diseases, and this has been confirmed by others.'.…”