Use of the Forced Oscillation Technique to Assess Airway Obstruction and Reversibility in Children
| Autor: | Bruno Housset, Christophe Delacourt, Hubert Lorino, Martine Herve-Guillot, Alain Harf, Philippe Reinert |
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| Rok vydání: | 2000 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent medicine.drug_class Vital Capacity Critical Care and Intensive Care Medicine Sensitivity and Specificity Pulmonary function testing Forced Oscillation Technique Forced Expiratory Volume Oscillometry Bronchodilator Internal medicine Administration Inhalation medicine Humans Albuterol Lung Diseases Obstructive Child Tidal volume Asthma Inhalation Receiver operating characteristic business.industry Airway Resistance Airway obstruction medicine.disease Bronchodilator Agents Surgery Treatment Outcome Child Preschool Cardiology Female business |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 161:730-736 |
| ISSN: | 1535-4970 1073-449X |
| Popis: | The forced oscillation technique (FOT) is particularly attractive in a pediatric setting as it requires only passive cooperation from the child. We assessed the sensitivity and specificity of this method for detecting airway obstruction and its reversibility in 313 children (3 to 16 yr of age) with asthma or chronic nocturnal cough. Baseline and postbronchodilator (n 5 251) resistance were measured (R 0 ) with the FOT. Baseline R 0 was normalized for height and weight [R 0 (SD)]. In children able to perform forced expiratory maneuvers (n 5 181), R 0 (SD) was independently correlated with FEV 1 (p , 0.02) and maximal expiratory flow at 50% (MEF 50 ) (p , 0.004). The optimal R 0 (SD) cutoff value given by receiver operating characteristic (ROC) curves to discriminate between children with baseline FEV 1 , 80% or > 80% of predicted values yielded 84% sensitivity and 73% specificity. Postbronchodilator changes in R 0 (SD) [ D R 0 (SD)] were mostly correlated to changes in MEF 50 . The optimal D R 0 (SD) cutoff value to discriminate between children with the presence or absence of significant reversibility in FEV 1 yielded 69% sensitivity and 78% specificity. In children unable to perform forced expiratory maneuvers (n 5 132), this D R 0 (SD) cutoff clearly identified a subgroup of young children with high R 0 values at baseline, that returned to normal after bronchodilation. We conclude that FOT measurements allow reliable evaluation of bronchial obstruction and its reversibility in asthmatic children over 3 yr old. Delacourt C, Lorino H, Herve-Guillot M, Reinert P, Harf A, Housset B. Use of the forced oscillation technique to assess airway obstruction and reversibility in children. AM J RESPIR CRIT CARE MED 2000;161:730‐736. The detection of airflow obstruction and its reversibility is a routine procedure in pediatric pulmonary function laboratories. Measurement of forced expiratory volume in one second (FEV 1 ) is considered to be the basic test for the assessment of airway obstruction. However, it is usually difficult to obtain in children younger than 6 yr of age because it is effort-dependent and therefore requires active cooperation from the child. An alternative method is measurement of the total resistance of the respiratory system (Rrs) with the forced oscillation technique (FOT). This method is particularly attractive as it requires only passive cooperation from the subject, who breathes quietly at tidal volume during the test. In children, the FOT has already proved useful for evaluating bronchial responsiveness to nonspecific agents (1‐3). In contrast, few studies have evaluated the ability of this method to detect bronchial obstruction in children and to assess changes following bronchodilator inhalation (4‐6). Moreover, there is no consensus on Rrs criteria for the identification and grading of airway obstruction. A significant correlation has been found between baseline FEV 1 and Rrs (4, 6), but it was also suggested that |
| Databáze: | OpenAIRE |
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