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Published ahead of print on July 17, 2003, doi:10.1164/rccm.200303-449OC

Am. J. Respir. Crit. Care Med., Volume 168, Number 6, September 2003, 640-644

A more recent version of this article appeared on September 15, 2003
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Submitted on March 28, 2003
Accepted on July 6, 2003

Pulmonary Function Tests in Asthmatic Preschool Children

NICOLE BEYDON1, ISABELLE PIN2, REGIS MATRAN3, MICHELE CHAUSSAIN4, MICHELE BOULE5, ALAIN BEUREY6, MIREILLE BELLET7, FRANCIS AMSALLEM8, CORINNE ALBERTI9, ANDRE DENJEAN10, and CLAUDE GAULTIER1*

1 Physiology, Robert Debre Hospital, Paris, France, 2 Pediatric, Grenoble Hospital, Grenoble, France, 3 Physiology, Calmette Hospital, Lille, France, 4 Physiology, Saint Vincent de Paul Hospital, Paris, France, 5 Physiology, Trousseau Hospital, Paris, France, 6 Pediatric, Centre Medical d'Observation Bio-Climatique, Font-Romeu, France, 7 Physiology, Morvan Hospital, Brest, France, 8 Physiology, Arnaud de Villeneuve Hospital, Montpellier, France, 9 Public Health, Robert Debre Hospital, Paris, France, 10 Physiology, Poitiers Hospital, Poitiers, France

* To whom correspondence should be addressed. E-mail: claude.gaultier{at}rdb.ap-hop-paris.fr.

Pulmonary function tests are seldom performed in preschool asthmatic children. The aim of this multicenter study was to compare pulmonary function in 74 preschool asthmatic children (height 90-130 cm) and 84 healthy controls. Functional residual capacity (helium dilution technique) and expiratory interrupter resistance (interrupter technique) were measured. As compared with control children, asthmatic children had significantly higher resistance (0.77±0.20 versus 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 asthmatic children 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 asthmatic children than in controls (-11.2±15.2% versus -18.6±13.6%, P<0.001 and -23.2±19.2% versus -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 asthmatic children from that in healthy controls. Pulmonary function tests that do not require active cooperation may help in the management and follow-up of asthmatic preschool children who are unable to perform forced expiratory maneuvers.
Key words: functional residual capacity, expiratory interrupter resistance, bronchodilator




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