Utility of bronchodilator response for asthma diagnosis in Latino preschoolers |
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| Institution: | 1. Pediatric Respiratory Section, Hospital Padre Hurtado, Santiago, Chile;2. Faculty of Medicine Clínica Alemana Universidad del Desarrollo, Santiago, Chile;3. Departments of Pediatrics and Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;1. Unidad de investigación en inmunodeficiencias, Instituto Nacional de Pediatría, Mexico;2. Servicio de Inmunología, Instituto Nacional de Pediatría, Mexico;3. Servicio de Alergia, Hospital del Niño Poblano, Mexico;4. Servicio de Inmunología y Alergia, Centro Médico Nacional 20 de Noviembre, Mexico;5. Departamento Clínico de Alergia e Inmunología, Hospital de Especialidades CMN la Raza, Mexico;6. Jefatura de Enseñanza, Hospital infantil del Estado de Chihuahua, Mexico;7. Servicio de Alergia, Hospital Infantil de México, Mexico;8. Servicio de Inmunología, Unidad médica de alta especialidad # 25 IMSS, Mexico;9. Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Mexico;10. Servicio de Dermatología, Instituto Nacional de Pediatría, Mexico;11. Servicio de Infectología, Hospital de Pediatría, CMN siglo XXI, Argentina;12. Departamento de Biomedicina Molecular, CINVESTAV-IPN, Mexico;1. Pamukkale University, Pamukkale School of Medicine, Department of Pediatrics, Denizli, Turkey;2. Clinic of Pediatrics, Department of Pediatrics, Division of Pediatric Allergy, Gaziantep, Turkey;3. Cumhuriyet University, Cumhuriyet School of Medicine, Department of Pediatrics, Division of Pediatric Allergy, Sivas, Turkey;4. Istanbul University, Istanbul School of Medicine, Department of Pediatrics, Division of Pediatric Allergy, Istanbul, Turkey;1. Department of Pediatric Respiratory Diseases and Allergy, The Medical University of Warsaw, Dzia?dowska 1, 01-184 Warsaw, Poland;2. Department of Paediatrics, The Medical University of Warsaw, Dzia?dowska 1, 01-184 Warsaw, Poland;1. Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain;2. Department of Pediatrics, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain;3. Hematology Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain;4. Pharmacy Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Spain;1. Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile;2. Microbiology Unit, Clinical Service Laboratories Red Salud Christus-UC, Pontificia Universidad Católica de Chile, Santiago, Chile;3. Division of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile |
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| Abstract: | BackgroundAsthma diagnosis in preschoolers is mostly based on clinical evidence, but a bronchodilator response could be used to help confirm the diagnosis. The objective of this study is to evaluate the utility of bronchodilator response for asthma diagnosis in preschoolers by using spirometry standardised for this specific age group.MethodsA standardised spirometry was performed before and after 200 mcg of salbutamol in 64 asthmatics and 32 healthy control preschoolers in a case-control design study.ResultsThe mean age of the population was 4.1 years (3–5.9 years) and 60% were females. Almost 95% of asthmatics and controls could perform an acceptable spirometry, but more asthmatics than controls reached forced expiratory volume in one second (FEV1) (57% vs. 23%, p = 0.033), independent of age. Basal flows and FEV1 were significantly lower in asthmatics than in controls, but no difference was found between groups in forced vital capacity (FVC) and FEV in 0.5 s (FEV0.5). Using receiver operating characteristic (ROC) curves, the variable with higher power to discriminate asthmatics from healthy controls was a bronchodilator response (% of change from basal above the coefficient of repeatability) of 25% in forced expiratory flow between 25% and 75% (FEF25–75) with 41% sensitivity, 80% specificity. The higher positive likelihood ratio for asthma equalled three for a bronchodilator response of 11% in FEV0.5 (sensitivity 30%, specificity 90%).ConclusionsIn this sample of Chilean preschoolers, spirometry had a very high performance and bronchodilator response was very specific but had low sensitivity to confirm asthma diagnosis. |
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| Keywords: | Asthma Bronchodilator response Diagnosis Preschoolers Spirometry |
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