Assessment and validation of bronchodilation using the interrupter technique in preschool children
- 23 June 2010
- journal article
- research article
- Published by Wiley in Pediatric Pulmonology
- Vol. 45 (7), 633-638
- https://doi.org/10.1002/ppul.21210
Abstract
Objective To determine and validate a cut‐off value for bronchodilation using the interrupter resistance (Rint) in preschool children. Patients and Methods Rint was measured in 60 healthy children (age range 2.7–6.4 years) before and after salbutamol inhalation (200 µg). Four potential methods for assessing BDR were evaluated: percent change from baseline, percent change of predicted values, absolute change in Rint, and change in Z‐score. These cut‐off values, determined as the fifth percentile of the healthy group, were applied to children referred for the assessment of recurrent wheezing, classified on the basis of acute symptoms and/or abnormal chest examination into symptomatic (n = 60, age range 2.9–6.1 years) and asymptomatic (n = 60, age range 2.5–5.7 years) groups. Results The cut‐off values for bronchodilation calculated in healthy children were: −32% baseline; −33% predicted; −0.26 kPa L−1 sec; and −1.25 Z‐scores. Assessing BDR in children with a history of wheezing by either a decrease in absolute Rint or a decrease in Z‐score gave sensitivity, specificity, negative predictive value, and positive predictive value all >80% for detecting children with current respiratory symptoms. Conclusions Both a decrease in Rint ≥0.26 kPa L−1 sec and a decrease in Z‐score of ≥1.25 are appropriate for assessing BDR in preschool children with a history of recurrent wheezing. As Z‐score is a more general solution, we recommend using a change in Z‐score to determine BDR in preschool children. Further longitudinal studies will be required to determine the clinical utility of measuring BDR in managing lung disease in such children. Pediatr Pulmonol. 2010; 45:633–638.Keywords
This publication has 17 references indexed in Scilit:
- Interrupter resistance short-term repeatability and bronchodilator response in preschool childrenRespiratory Medicine, 2007
- Standardisation of spirometryEuropean Respiratory Journal, 2005
- Pulmonary Function Tests in Preschool Children with AsthmaAmerican Journal of Respiratory and Critical Care Medicine, 2003
- Short and long term variability of the interrupter technique under field and standardised conditions in 3-6 year old childrenThorax, 2003
- Repeatability of airway resistance measurements made using the interrupter techniqueThorax, 2003
- Pulmonary Function Tests in Preschool Children with Cystic FibrosisAmerican Journal of Respiratory and Critical Care Medicine, 2002
- Reference values of interrupter respiratory resistance in healthy preschool white childrenThorax, 2001
- Discriminative Capacity of Bronchodilator Response Measured with Three Different Lung Function Techniques in Asthmatic and Healthy Children Aged 2 to 5 YearsAmerican Journal of Respiratory and Critical Care Medicine, 2001
- Asthma and Wheezing in the First Six Years of LifeThe New England Journal of Medicine, 1995
- Reversibility of airflow obstruction: FEV1 vs peak flowThe Lancet, 1992