BACKGROUND: In young children, it is difficult to obtain a reproducible flow-volume curve throughout all stages of bronchial challenge. The forced oscillation technique (FOT) is especially established in paediatrics because this method does not require forced or maximal manoeuvres and is less cooperation-dependent than conventional spirometry. OBJECTIVES: To evaluate the association of spirometric and impulse oscillometric (IOS) indices in a short protocol for methacholine provocation. METHODS: The primary endpoint was the methacholine dose that caused a 20% decrease in FEV(1) (PD(-20)FEV(1)) compared to baseline. Changes in respiratory resistance (Rrs5) and reactance (Xrs5) acquired by IOS were compared with FEV(1). RESULTS: Forty-eight children (5.3 ± 0.9 years) were challenged. The mean maximal reduction in FEV(1) was 29.8% ± 14.7 (p < 0.0001), the mean increase in Rsr5 was 55.3% ± 31.7, and the mean decrease in Xrs5 was 0.37 kPa s L(-1) ± 0.23 (p < 0.001). An increase in Rrs5 of 45.2% and a decrease in Xrs5 of 0.69 kPa s L(-1) showed the optimal combination of sensitivity and specificity to detect a 20% reduction in FEV(1) (0.72 and 0.73; 0.80 and 0.76, respectively), and the area under the ROC curve was 0.76 and 0.81, respectively (p < 0.005). In 28 patients with significant changes in FEV(1) and Rsr5, the PD(-20)FEV(1) was 0.48 mg methacholine ±0.59 and the PD(+40)Rrs5 was 0.28 mg methacholine ±0.45 (p = 0.03). CONCLUSIONS: A short protocol for methacholine challenge testing is feasible in young children. IOS detected 70-80% of patients who responded in spirometry. During the challenge, the Rrs5 response preceded the FEV(1) response.
BACKGROUND: In young children, it is difficult to obtain a reproducible flow-volume curve throughout all stages of bronchial challenge. The forced oscillation technique (FOT) is especially established in paediatrics because this method does not require forced or maximal manoeuvres and is less cooperation-dependent than conventional spirometry. OBJECTIVES: To evaluate the association of spirometric and impulse oscillometric (IOS) indices in a short protocol for methacholine provocation. METHODS: The primary endpoint was the methacholine dose that caused a 20% decrease in FEV(1) (PD(-20)FEV(1)) compared to baseline. Changes in respiratory resistance (Rrs5) and reactance (Xrs5) acquired by IOS were compared with FEV(1). RESULTS: Forty-eight children (5.3 ± 0.9 years) were challenged. The mean maximal reduction in FEV(1) was 29.8% ± 14.7 (p < 0.0001), the mean increase in Rsr5 was 55.3% ± 31.7, and the mean decrease in Xrs5 was 0.37 kPa s L(-1) ± 0.23 (p < 0.001). An increase in Rrs5 of 45.2% and a decrease in Xrs5 of 0.69 kPa s L(-1) showed the optimal combination of sensitivity and specificity to detect a 20% reduction in FEV(1) (0.72 and 0.73; 0.80 and 0.76, respectively), and the area under the ROC curve was 0.76 and 0.81, respectively (p < 0.005). In 28 patients with significant changes in FEV(1) and Rsr5, the PD(-20)FEV(1) was 0.48 mg methacholine ±0.59 and the PD(+40)Rrs5 was 0.28 mg methacholine ±0.45 (p = 0.03). CONCLUSIONS: A short protocol for methacholine challenge testing is feasible in young children. IOS detected 70-80% of patients who responded in spirometry. During the challenge, the Rrs5 response preceded the FEV(1) response.
Authors: Daniel Chang; Weiguo Yao; Christina J Tiller; Jeffrey Kisling; James E Slaven; Zhangsheng Yu; Mark H Kaplan; Robert S Tepper Journal: Eur Respir J Date: 2014-09-26 Impact factor: 16.671
Authors: Marek L Kowalski; Ignacio Ansotegui; Werner Aberer; Mona Al-Ahmad; Mubeccel Akdis; Barbara K Ballmer-Weber; Kirsten Beyer; Miguel Blanca; Simon Brown; Chaweewan Bunnag; Arnaldo Capriles Hulett; Mariana Castells; Hiok Hee Chng; Frederic De Blay; Motohiro Ebisawa; Stanley Fineman; David B K Golden; Tari Haahtela; Michael Kaliner; Connie Katelaris; Bee Wah Lee; Joanna Makowska; Ulrich Muller; Joaquim Mullol; John Oppenheimer; Hae-Sim Park; James Parkerson; Giovanni Passalacqua; Ruby Pawankar; Harald Renz; Franziska Rueff; Mario Sanchez-Borges; Joaquin Sastre; Glenis Scadding; Scott Sicherer; Pongsakorn Tantilipikorn; James Tracy; Vera van Kempen; Barbara Bohle; G Walter Canonica; Luis Caraballo; Maximiliano Gomez; Komei Ito; Erika Jensen-Jarolim; Mark Larche; Giovanni Melioli; Lars K Poulsen; Rudolf Valenta; Torsten Zuberbier Journal: World Allergy Organ J Date: 2016-10-12 Impact factor: 4.084
Authors: Stanley P Galant; Hirsh D Komarow; Hye-Won Shin; Salman Siddiqui; Brian J Lipworth Journal: Ann Allergy Asthma Immunol Date: 2017-06 Impact factor: 6.347
Authors: Sun Hee Choi; Youn Ho Sheen; Mi Ae Kim; Ji Hyeon Baek; Hey Sung Baek; Seung Jin Lee; Jung Won Yoon; Yeong Ho Rha; Man Yong Han Journal: Biomed Res Int Date: 2017-06-27 Impact factor: 3.411