Small airway function in children with mild to moderate asthmatic symptoms
| Autor: | Hanna Knihtilä, Anna S. Pelkonen, L. Pekka Malmberg, Anne Kotaniemi-Syrjänen, Mika J. Mäkelä |
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| Přispěvatelé: | Department of Dermatology, Allergology and Venereology, Clinicum, University of Helsinki, HUS Inflammation Center |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Vital capacity PRESCHOOL-CHILDREN CLINICAL-APPLICATIONS Respiratory System 0302 clinical medicine 3123 Gynaecology and paediatrics Immunology and Allergy Medicine 030212 general & internal medicine Child medicine.diagnostic_test Nitrogen washout 3. Good health Respiratory Function Tests Asthma Exercise-Induced Breath Tests Child Preschool GUIDELINE Bronchoconstriction Female medicine.symptom Pulmonary and Respiratory Medicine Spirometry EXHALED NITRIC-OXIDE medicine.medical_specialty Immunology Nitric Oxide FORCED OSCILLATION 03 medical and health sciences INFLAMMATION Internal medicine Oscillometry Humans ALVEOLAR Adrenergic beta-2 Receptor Agonists Asthma OBSTRUCTION MARKERS business.industry Airway obstruction medicine.disease SPIROMETRY respiratory tract diseases Airway Obstruction 030228 respiratory system 3121 General medicine internal medicine and other clinical medicine Exhaled nitric oxide VENTILATION HETEROGENEITY business Airway |
| Popis: | Background: Clinical significance of small airway obstruction in mild pediatric asthma is unclear. Objective: To evaluate small airway properties in children with mild to moderate asthmatic symptoms and the association of small airway function with asthma control and exercise-induced bronchoconstriction (EIB). Methods: Children (5-10 years old) with recurrent wheezing (n = 42) or persistent troublesome cough (n = 16) and healthy controls (n = 19) performed impulse oscillometry (IOS), spirometry, and a multiple-breath nitrogen washout (MBNW) test. Exhaled nitric oxide (NO) was measured at multiple flow rates to determine alveolar NO concentration (CAIN). Asthma control was evaluated with the Childhood Asthma Control Test (C-ACT), short-acting beta(2)-agonist (SABA) use within the past month, and asthma exacerbations within the past year. Results: IOS, spirometry, and exhaled NO indexes that are related to small airway function differed between children with recurrent wheezing and healthy controls, whereas only forced expiratory flow at 25% to 75% of the forced vital capacity was associated with persistent cough. The MBNW indexes showed no difference between the groups. Among symptomatic children, conducting airway ventilation inhomogeneity and CALV were associated with asthma exacerbations (P = .03 and P = .002, respectively), and lung clearance index and CALV were associated with EIB (P = .04 and P = .004, respectively). None of the proposed small airway indexes was associated with the C-ACT score or SABA use. Conclusion: Subtle changes were observed in the proposed small airway indexes of IOS, spirometry, and exhaled NO among children with mild to moderate recurrent wheezing. Small airway dysfunction, expressed as ventilation inhomogeneity indexes and CALV, was also associated with asthma exacerbations and EIB. (C) 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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