Relationship between bronchial hyperresponsiveness and lung function in children age 5 and 6 with and without asthma

Takami, Satoru; Mochizuki, Hiroyuki; Muramatsu, Reiko; Hagiwara, Satomi; Arakawa, Hirokazu

doi:10.1111/resp.12061

Cited by 4 publications

(4 citation statements)

References 31 publications

(67 reference statements)

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“…Bronchial hyper-responsiveness studies comparing FOT with different lung function measures have reported FOT to be as effective as spirometry[ 63 - 69 ] and as sensitive as body plethysmography[ 70 ] and transcutaneous PO 2 [ 50 ] in older children with asthma. BHR has been assessed using FOT in children younger than 7 years of age with a range of challenge tests including adenosine monophosphate (AMP)[ 19 ], cold air[ 24 ], normal saline[ 21 ] methacholine[ 22 , 62 , 63 , 66 , 68 , 71 ], mannitol[ 25 ] and exercise[ 20 , 72 ] demonstrating that FOT can be reliably used in young children for challenge testing.…”

Section: Introductionmentioning

confidence: 99%

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Alblooshi¹,

Alkalbani²,

Albadi³

et al. 2017

WJM

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Respiratory diseases, especially asthma, are common in children. While spirometry contributes to asthma diagnosis and management in older children, it has a limited role in younger children whom are often unable to perform forced expiratory manoeuvre. The development of novel diagnostic methods which require minimal effort, such as forced oscillation technique (FOT) is, therefore, a welcome and promising addition. FOT involves applying external, small amplitude oscillations to the respiratory system during tidal breathing. Therefore, it requires minimal effort and cooperation. The FOT has the potential to facilitate asthma diagnosis and management in pre-school children by faciliting the objective measurement of baseline lung function and airway reactivity in children unable to successfully perform spirometry. Traditionally the use of FOT was limited to specialised centres. However, the availability of commercial equipment resulted in its use both in research and in clinical practice. In this article, we review the available literature on the use of FOT in childhood asthma. The technical aspects of FOT are described followed by a discussion of its practical aspects in the clinical field including the measurement of baseline lung function and associated reference ranges, bronchodilator responsiveness and bronchial hyper-responsiveness. We also highlight the difficulties and limitations that might be encountered and future research directions.

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Section: Introductionmentioning

confidence: 99%

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Alblooshi¹,

Alkalbani²,

Albadi³

et al. 2017

WJM

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“…Baseline lung function by spirometry [26] and the IOS [27] are the major determinants for measuring BHR. It is well known that the IOS parameters, particularly Rrs, are more sensitive to changes in airway obstruction than other lung function tests [10, 14, 15, 28].…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Oscillatory Lung Function during Methacholine Bronchoprovocation Testing of Preschool Children

Choi

Sheen

Kim

et al. 2017

BioMed Research International

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Objective To investigate the repeatability and safety of measuring impulse oscillation system (IOS) parameters and the point of wheezing during bronchoprovocation testing of preschool children. Methods Two sets of methacholine challenge were conducted in 36 asthma children. The test was discontinued if there was a significant change in reactance (Xrs5) and resistance (Rrs5) at 5 Hz (Condition 1) or respiratory distress due to airway obstruction (Condition 2). The repeatability of PC80_Xrs5, PC30_Rrs5, and wheezing (PCw) was assessed. The changes in Z-scores and SD-indexes from prebaseline (before testing) to postbaseline (after bronchodilator) were determined. Results For PC30_Rrs5, PC80_Xrs5, and PCw for subjects, PC80_Xrs5 showed the highest repeatability. Fifteen of 70 tests met Condition 2. The changes from pre- and postbaseline values varied significantly for Rrs5 and Xrs5. Excluding subjects with Z-scores higher than 2SD, we were able to detect 97.1% of bronchial hyperresponsiveness during methacholine challenge based on the change in Rrs5 or Xrs5. A change in IOS parameters was associated with wheezing at all frequencies. Conclusion Xrs5 and Rrs5 have repeatability comparable with FEV1, and Xrs5 is more reliable than Rrs5. Clinicians can safely perform a challenge test by measuring the changes in Rrs5, Xrs5, and Z-scores from the prebaseline values.

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“…challenges were performed by Astograph aerosol generator (J-21; Chest Company; Tokyo, Japan) delivered increasing doses of methacholine from 12 serially arranged nebulizers (17). Dmin was the cumulative dose of methacholine at the inflection point of the respiratory resistance (Rrs) tracing.…”

Section: Methacholine Inhalation Challenge Methacholine Inhalationmentioning

confidence: 99%

Airway hyper-responsiveness and small airway function in children with well-controlled asthma

Huang

Zhang

et al. 2015

Pediatr Res

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Background: Airway hyper-responsiveness (AHR) and small airway function are critical to children with asthma. Little is known about the role of the small airway in well-controlled subjects with AHR. We aimed to evaluate AHR and small airway function in children with well-controlled asthma, and to investigate the association between them. Methods: We studied 116 cases of children with well-controlled asthma (group A), 46 cases healthy children as controls (group C). Spirometry, impulse oscillometry (IOS), and methacholine challenge test (MCT) were conducted on all the children. results: (i) Group A and group C had no differences in forced expiratory volume in 1 s (FEV 1 ) and FEV 1 /forced vital capacity (FVC) ratio (P > 0.05). Forced expiratory flow between 25 and 75% of vital capacity ) and reactance at 5 Hz (X5) in group A were significantly lower than those in group C. (ii) One hundred and five cases (90.5%) of group A proved positive to MCT. (iii) FEF in group A proved positive to MCT but were lower than those proved negative (P < 0.05). conclusion: AHR persisted in majority of children with well-controlled asthma. Among children with well-controlled asthma, small airway function was lower in those with AHR than those without AHR. a sthma is the most common chronic lower respiratory disease in childhood throughout the world. The newest Global Initiative for Asthma guidelines, as well as international consensus on pediatric asthma suggested that, after initial severity assessment, ongoing care should include continual assessment of the patient's asthma control in terms of real-life activities (1,2). This approach uses a cycle of detailed assessment and intervention to achieve and maintain asthma control. The level of control is defined by frequency of asthma symptoms, and the degree of lung function (forced expiratory volume in 1 s (FEV 1 ), peak expiratory flow). But in some cases called "well controlled asthma" with no disease activity and normal lung function, how can we evaluate and manage them? Airway hyper-responsiveness (AHR) is a clinical feature of asthma and is often in proportion to the underlying severity of the disease. AHR of children with well-controlled asthma can display condition of the disease. But, the evaluation of AHR is not popular in pediatric clinic. In areas without this means, how can we do next?Asthma is an inflammatory airway disorder that involves also the small airways (defined as the peripheral membranous bronchioles <2 mm in diameter) (3). Two decades ago, Wagner et al. (4) demonstrated a more than sevenfold increase in small airway resistance in asymptomatic asthma with normal spirometry (FEV 1 and forced vital capacity (FVC)). The contribution of the small airways to the development of the clinical features and functional impairment in asthma is incompletely understood (5). Study suggested that asthmatics with AHR have more severe small airways obstruction, but little is known about the role of the small airways in asymptomatic subjects with AHR. Therefore, the aim of our...

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Relationship between bronchial hyperresponsiveness and lung function in children age 5 and 6 with and without asthma

Abstract: Our data suggest that it not possible to distinguish preschool children with asthma from non-asthmatic wheezers based on their bronchial sensitivity and that the baseline Rrs has a strong effect on the bronchial reactivity in children.

Cited by 4 publications

References 31 publications

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Is forced oscillation technique the next respiratory function test of choice in childhood asthma

Clinical Implications of Oscillatory Lung Function during Methacholine Bronchoprovocation Testing of Preschool Children

Airway hyper-responsiveness and small airway function in children with well-controlled asthma

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