• Arch. Dis. Child. · Feb 2013

    Bronchodilator responsiveness using spirometry in healthy and asthmatic preschool children.

    • Luis Miguel Borrego, Janet Stocks, Isabel Almeida, Sanja Stanojevic, João Antunes, Paula Leiria-Pinto, José E Rosado-Pinto, and Ah-Fong Hoo.
    • Departamento de Imunologia, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria 123, Lisboa 1150-227, Portugal. borregolm@gmail.com
    • Arch. Dis. Child. 2013 Feb 1; 98 (2): 112-7.

    ObjectiveTo assess repeatability and reproducibility of spirometry measurements, and bronchodilator responsiveness (BDR), in healthy 3-6-year-old preschool children and those with asthma.DesignSpirometry was performed before and 20 minutes after administering either inhaled placebo (for repeatability) or 400 μg salbutamol (for BDR) on two separate occasions (reproducibility) 3-23 days apart in asthmatic preschoolers and healthy controls.SettingsLung Function Laboratory, Hospital de Dona Estefania, Lisbon.ParticipantsHealthy preschool children and those with physician-diagnosed asthma, recruited from local Health Clinics and Outpatient Clinic.Main Outcome MeasuresPaired measurements of forced expired volume in 0.75 s (FEV(0.75)) and forced mid-expiratory flows (FEF(25-75)).ResultsTechnically successful baseline results were obtained in 86% of children assessed. Paired data were obtained in 43 asthmatic and 22 controls (median (range) age: 5.1 (3.4-6.8) years). Baseline FEV(0.75) was significantly lower in asthmatic children (mean (SD): 90 (15)% predicted) than in controls (102 (13) % predicted; p<0.001). Within-occasion coefficient of repeatability following placebo was similar in both groups, being 10.4% in asthma and 13.2% in controls for FEV(0.75). Following bronchodilator, FEV(0.75) increased significantly more in asthmatic preschoolers (mean (SD): 15.0 (12) %) than in controls (4.5 (5) %; p<0.001), with no significant difference between groups post-bronchodilator. Between-occasion variability was similar to within-day repeatability in controls, but almost twice as high in asthmatic children.ConclusionsBDR can be assessed reliably using FEV(0.75) in wheezy preschoolers, provided within-subject variability and responsiveness in health are taken into consideration.

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