Comparison of respiratory inductance plethysmography with thoracoabdominal compression in bronchial challenges in infants and young children.
Respiratory inductance plethysmography measuring thoracoabdominal asynchrony (TAA) has been claimed to be a useful tool for measuring changes in airway resistance in infants. In this study we evaluated the response to methacholine by thoracoabdominal compression and respiratory inductance plethysmography. Seventeen infants (mean age, 13.1 +/- 4.7 mo) with recurrent episodes of cough or wheeze underwent bronchial challenge with inhaled methacholine. Lung function was evaluated by measuring maximal expiratory flow at resting lung volume (VmaxFRC), and the degree of TAA was measured by phase angle (theta). Methacholine was inhaled for 1 min during tidal breathing using increasing doubling concentrations until a fall of at least 40% in VmaxFRC was achieved (final concentration). All infants responded to the final concentration of methacholine by a significant fall in VmaxFRC (from 31 +/- 10 to 12 +/- 5 ml/s/kg, p < 0.001). All but one infant responded to methacholine at the final concentration with a significant increase in phase angle (median theta increased from 11.7 to 31.7 degrees, p < 0.001). In two other infants there was an early response in theta compared with the response in VmaxFRC. Phase angle increase after methacholine was expressed as Z-scores (the difference between postmethacholine theta and postbuffer theta divided by the standard deviation of postbuffer theta). An increase of at least 2.0 Z-scores in theta was observed at the same concentration of methacholine when VmaxFRC fell by at least 40% in 15 of the 17 infants (88%). We conclude that respiratory inductance plethysmography is a sensitive method to measure bronchial reactivity to methacholine in most of the infants studied (14 of 17, 82%). A concentration of methacholine causing an increase in theta of at least 2.0 standard deviations above baseline is equivalent to the concentration causing a 40% fall in VmaxFRC.
Springer
C
C
Institute of Pulmonology, Hadassah University Hospital, Jerusalem, Israel.
Godfrey
S
S
Vilozni
D
D
Bar-Yishay
E
E
Noviski
N
N
Avital
A
A
D000403:Airway Resistance; D001249:Asthma / Q000175:diagnosis / Q000503:physiopathology; D001985:Bronchial Provocation Tests / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008448:Maximal Expiratory Flow Rate / Q000187:drug effects; D008449:Maximal Expiratory Flow-Volume Curves / Q000187:drug effects; D016210:Methacholine Chloride; D010366:Peak Expiratory Flow Rate; D010991:Plethysmography / Q000379:methods; D011312:Pressure
D016210:Methacholine Chloride