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Modulation of airway caliber by deep inhalation in children
M Milanese1, C Mondino, M Tosca
1Centro di Fisiopatologia Respiratoria, Dipartimento di Scienze Motorie e Riabilitative e Clinica delle Malattie dell' Apparato Respiratorio ed Allergologia, Dipartimento di Medicina Interna, Università di Genova, 16132 Genova, Italy.
Insights
Deep inhalation (DI) helps reverse airway narrowing in young children with recurrent wheezing. This suggests that the connection between airways and lung tissue is active even in early childhood.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Recurrent wheezing in children is a common condition affecting airway function.
- The role of deep inhalation (DI) in modulating airway caliber in pediatric populations is not fully understood.
Purpose of the Study:
- To investigate whether deep inhalation (DI) influences changes in airway caliber in children aged 4 to 7 years.
- To assess the effect of DI on respiratory impedance following pharmacological bronchoconstriction and bronchodilation.
Main Methods:
- Respiratory impedance was measured in 15 children (4-7 years) with recurrent wheezing.
- Measurements were taken before and after inhaled methacholine (bronchoconstrictor) or salbutamol (bronchodilator).
- The impact of deep inhalation on respiratory impedance parameters was analyzed.
Main Results:
- Methacholine increased respiratory impedance (Re[Z](12-16)) and resonance frequency, which were partially reversed by DI.
- Salbutamol decreased respiratory impedance, and this decrease was also partially reversed by DI.
- DI modulated pharmacologically induced changes in airway caliber in this age group.
Conclusions:
- Deep inhalation plays a role in modulating airway caliber changes in young children (4-7 years) with recurrent wheezing.
- These findings indicate that airway-to-parenchyma interdependence is functional in this age range.
- DI may be a relevant factor in managing airway hyperresponsiveness in pediatric wheezing.
Abstract:
To elucidate whether deep inhalation (DI) modulates changes in airway caliber in childhood, we measured the effect of DI on respiratory impedance before and after inhaled methacholine or salbutamol in 4- to 7-yr-old children (n = 15) suffering from recurrent wheezing. In all children, the real part of impedance between 12 and 16 Hz (Re[Z](12-16)) increased after methacholine from 5.6 +/- 1.2 to 8.2 +/- 1.6 cmH(2)O. l(-1). s (P < 0.001) and resonance frequency from 18 +/- 3 to 25 +/- 5 Hz (P < 0.001). These changes were partially reversed by DI: Re[Z](12-16) decreased to 7.2 +/- 1.2 cmH(2)O. l(-1). s (P < 0.01) and resonance frequency to 19 +/- 5 Hz (P < 0.001). In nine children, on a separate occasion, Re[Z](12-16) decreased after salbutamol from 8.3 +/- 1.9 to 5.1 +/- 0.9 cmH(2)O. l(-1). s (P < 0.001) and resonance frequency from 21 +/- 6 to 15 +/- 3 Hz (P < 0.05). The decrease of Re[Z](12-16) was partially reversed by DI (to 6.2 +/- 1.4 cmH(2)O. l(-1). s, P < 0. 01), but resonance frequency did not change significantly (P = 0.75). We conclude that in 4- to 7-yr-old children pharmacologically induced changes in airway caliber are modulated by DI. These findings suggest that airway-to-parenchyma interdependence is operative in this age range.