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Published ahead of print on July 17, 2003, doi:10.1164/rccm.200303-449OC
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American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 640-644, (2003)
© 2003 American Thoracic Society

Original Article

Pulmonary Function Tests in Preschool Children with Asthma

Nicole Beydon, Isabelle Pin, Régis Matran, Michèle Chaussain, Michèle Boulé, Beurey Alain, Mireille Bellet, Francis Amsallem, Corinne Alberti, André Denjean and Claude Gaultier the French Paediatric Programme Hospitalier de Recherche Clinique Group

Physiology and Public Health Departments of the Robert Debré Teaching Hospital; Pediatric Departments of the Grenoble Teaching Hospital, Grenoble; Arnaud de Villeneuve Teaching Hospital, Montpellier; Centre Médical d'Observation Bio-Climatique, Font-Romeu; Physiology Departments of the Calmette Teaching Hospital, Lille; Saint-Vincent-de-Paul Teaching Hospital and Trousseau Teaching Hospital, Paris; Morvan Teaching Hospital, Brest; and Poitiers Teaching Hospital, Poitiers, France

Correspondence and requests for reprints should be addressed to Claude Gaultier, Service de Physiologie, Hôpital Robert Debré, 48 Boulevard Sérurier, 75019 Paris, France. E-mail: claude.gaultier{at}rdb.ap-hop-paris.fr

Pulmonary function tests are seldom performed in preschool children with asthma. The aim of this multicenter study was to compare pulmonary function in 74 preschool children with asthma (height of 90–130 cm) and 84 healthy control subjects. Functional residual capacity (helium dilution technique) and expiratory interrupter resistance (interrupter technique) were measured. As compared with control children, children with asthma had a significantly higher resistance (0.77 ± 0.20 vs. 0.92 ± 0.22 kPa · L-1 · second, p < 0.001) and significantly lower specific expiratory interrupter conductance (p < 0.005) values. Resistance values were significantly higher in children with asthma with than without symptoms on exertion (p < 0.05). The effect of bronchodilator administration, expressed as the percentage of baseline and predicted resistance values, was significantly greater in children with asthma than in control subjects (-18.6 ± 13.6% vs. -11.2 ± 15.2%, p <= 0.001, and -23.2 ± 19.2% vs. -12.6 ± 17.8%, p < 0.001), respectively. A 35% decrease in resistance after bronchodilation expressed as the percentage of predicted values had a likelihood ratio of 3 for separating the bronchodilator response in children with asthma from that in healthy control subjects. Pulmonary function tests that do not require active cooperation may help in the management and follow-up of preschool children with asthma who are unable to perform forced expiratory maneuvers.

Key Words: functional residual capacity • expiratory interrupter resistance • bronchodilator




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