title: Assessment of Airway Bronchodilation by Spirometry Compared to Airway Obstruction in Young Children with Asthma.
abstract: A reversibility test by an increase of greater than 12% in FEV1 can support a diagnosis of asthma and alter a patient's treatment plan but may not be applicable to the young ages. We retrospectively gathered spirometric data from 85/271 asthmatic children having mild obstruction (FEV1 > 80% predicted), age 2.6-6.9 years. Spirometry was performed before and 20 min after inhalation of 200 mcg Albuterol. We defined a deviation below -1.64 z scores from control as obstruction and an increased above 1.64 scores from control as a positive response to bronchodilators. Sensitivity of the index was considered significant if it captured >68% of the participants. The sensitivity of detecting airway obstruction in these children by FEV1 was 15.3% and 62.4% by FEF25-75. A positive response to Albuterol was an increase of 9.2% for FEV1 (12% for adults) and 18.5% for FEF25-75. The sensitivity for detecting a response to Albuterol in mild asthma was 64.7% by FEV1 and 91.8% by FEF25-75. Young children having normal spirometry can demonstrate airway reversibility. The response of spirometry parameters to bronchodilators may be more sensitive than obstruction detection and may help to support the diagnosis of asthma and adjust treatment plan.
authors.affiliation: Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, 31096 Haifa, Israel; The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Sackler Medical School, 52621 Tel Aviv, Israel.
authors.forename: Daphna
authors.initials: D
authors.lastname: Vilozni
authors.affiliation: Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, 31096 Haifa, Israel; The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 31096 Haifa, Israel.
authors.forename: Fahed
authors.identifier: 0000-0003-1452-5396
authors.initials: F
authors.lastname: Hakim
authors.affiliation: Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, 31096 Haifa, Israel.
authors.forename: Galit
authors.initials: G
authors.lastname: Livnat
authors.affiliation: The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Sackler Medical School, 52621 Tel Aviv, Israel.
authors.forename: Miryam
authors.identifier: 0000-0002-1271-7469
authors.initials: M
authors.lastname: Ofek
authors.affiliation: Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, 31096 Haifa, Israel.
authors.forename: Ronen
authors.initials: R
authors.lastname: Bar-Yoseph
authors.affiliation: Pediatric Pulmonary Institute, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, 31096 Haifa, Israel; The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 31096 Haifa, Israel.
authors.forename: Lea
authors.identifier: 0000-0002-5503-166X
authors.initials: L
authors.lastname: Bentur
mesh_terms: D000402:Airway Obstruction / Q000175:diagnosis*; D000420:Albuterol; D001249:Asthma / Q000175:diagnosis*; D001993:Bronchodilator Agents; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013147:Spirometry / Q000706:statistics & numerical data*
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol