Abnormal small airways function in children with mild asthma

Singer, Florian; Abbas, Chiara Carolina; Yammine, Sophie; Casaulta Aebischer, Carmen; Frey, Urs; Latzin, Philipp (2014). Abnormal small airways function in children with mild asthma. Chest, 145(3), pp. 492-499. American College of Chest Physicians 10.1378/chest.13-0784

[img] Text
chest_145_3_492.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (876kB) | Request a copy

BACKGROUND Small airways disease is a hallmark in adults with persistent asthma, but little is known about small airways function in children with mild asthma and normal spirometry. We assessed ventilation heterogeneity, a marker of small airways function, with an easy tidal breath single-breath washout (SBW) technique in school-aged children with mild asthma and normal FEV1 and healthy age-matched control subjects. METHODS The primary outcome was the double-tracer gas phase III slope (SDTG), an index of ventilation heterogeneity in acinar airways derived from the tidal double-tracer gas SBW test. The second outcome was the nitrogen phase III slope (SN2), an index of global ventilation heterogeneity derived from the tidal nitrogen SBW test using pure oxygen. Triplicate SBW and spirometry tests were performed in healthy children (n = 35) and children with asthma (n = 31) at baseline and in children with asthma after bronchodilation. RESULTS Acinar (SDTG) but not global (SN2) ventilation heterogeneity was significantly increased in asthma despite normal FEV1. Of the 31 children with asthma, abnormal results were found for SDTG (≤ -2 z scores) in 11; forced expiratory flow, midexpiratory phase (FEF25%-75%) in three; and FEV1 in zero. After bronchodilation, SDTG, SN2, FEF25%-75%, and FEV1 significantly changed (mean [95% CI] change from baseline, 36% [15%-56%], 38% [18%-58%], 17% [9-25%], and 6% [3%-9%], respectively). CONCLUSIONS Abnormal acinar ventilation heterogeneity in one-third of the children suggests that small airways disease may be present despite rare and mild asthma symptoms and normal spirometry. The easy tidal SBW technique has considerable potential as a clinical and research outcome in children with asthma.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)

UniBE Contributor:

Singer, Florian; Abbas, Chiara Carolina; Yammine, Sophie; Casaulta Aebischer, Carmen and Latzin, Philipp

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0012-3692

Publisher:

American College of Chest Physicians

Language:

English

Submitter:

André Schaller

Date Deposited:

24 Jul 2014 17:40

Last Modified:

02 Jan 2015 00:57

Publisher DOI:

10.1378/chest.13-0784

PubMed ID:

24091465

BORIS DOI:

10.7892/boris.44135

URI:

https://boris.unibe.ch/id/eprint/44135

Actions (login required)

Edit item Edit item
Provide Feedback