Pediatric pulmonology year in review 2019: Physiology

Rhoads, Eli; Wall, Brittany L; Ren, Clement L.

doi:10.1002/ppul.24995

Cited by 1 publication

(2 citation statements)

References 32 publications

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“…However, our current study aimed to highlight a different aspect of the role of BCTs in young children to emphasize their practical utility in clinical practice. Regarding this aspect, it has been claimed that the clinical value of bronchoprovocation in these children had not yet been established 18 . In our study we tried to shed some light on this topic.…”

Section: Discussionmentioning

confidence: 91%

“…Our recent study which focused on predicting asthma in school‐aged children using BCT with adenosine or methacholine in preschoolers, was selected for the last published Pediatric Pulmonology year in review 15,18 . However, the authors of the review stated that the clinical value of bronchoprovocation in these children had not yet been established.…”

Section: Introductionmentioning

confidence: 99%

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The role of bronchial challenge test in guiding therapy in preschool children with atypical recurrent respiratory symptoms

Wolfson,

Mandelberg,

Golan‐Lagziel

et al. 2023

Pediatric Pulmonology

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ObjectiveThis retrospective observational cohort study aimed to assess the real‐life application of bronchial challenge test (BCT) in the management of preschool children presenting with atypical recurrent respiratory symptoms (ARRS).MethodsWe included children aged 0.5–6 years referred to a pediatric‐pulmonology clinic who underwent BCT using methacholine or adenosine between 2012 and 2018 due to ARRS. BCT was considered positive based on spirometry results and/or wheezing, desaturation, and tachypnea reactions. We collected data on demographics, BCT results, pre‐BCT and post‐BCT treatment changes, and 3–6 months post‐BCT compliance and symptom control. The primary outcome measure was the change in treatment post‐BCT (step‐up or step‐down).ResultsA total of 228 children (55% males) with a mean age of 4.2 ± 0.6 years underwent BCT (52% adenosine‐BCT, 48% methacholine‐BCT). Children referred for methacholine were significantly younger compared with adenosine (3.6 ± 1.2 vs. 4.2 ± 1.2 years, p < .01). Methacholine and adenosine BCTs were positive in 95% and 61%, respectively. Overall, changes in management were observed in 122 (53.5%) children following BCT, with 83 (36.4%) being stepped up and 37 (17%) being stepped down. Significantly more children in the methacholine group were stepped up compared with the adenosine group (46% vs. 28%, p = .004). During the follow‐up assessment, we observed a clinical improvement in 119/162 (73.4%) of the children, with nearly 87% being compliant.ConclusionThis study demonstrates the importance of BCT in the management of preschool children presenting to pediatric pulmonary units with ARRS. The change in treatment and subsequent clinical improvement observed highlight the added value of BCT to the pulmonologist.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%