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Comparison of subjective and objective measures in recurrently wheezy infants
Johannes H Wildhaber1, Nigel D Dore, Sunalene G Devadason
1Swiss Paediatric Respiratory Physiology Research Group, Department of Respiratory Medicine, University Children's Hospital, Zürich, Switzerland. johannes.wildhaber@kispi.unizh.ch
Insights
Objective lung function tests, specifically forced expiratory volumes (FEV(t)) using the raised volume rapid thoracic compression technique, correlate well with physician assessments in wheezy infants. This contrasts with maximal flow at functional residual capacity (VmaxFRC) measurements.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Infant Health
Background:
- Recurrently wheezy infants present diagnostic challenges.
- Subjective health assessments may not fully capture objective lung function.
- Objective lung function measurements are crucial for monitoring infant respiratory health.
Purpose of the Study:
- To compare subjective health assessments with objective lung function measurements in wheezy infants.
- To evaluate the utility of forced expiratory volumes (FEV(t)) and maximal flow at functional residual capacity (VmaxFRC) in this population.
- To determine the correlation between physician and mother's overall health assessment and objective lung function data.
Main Methods:
- Sixteen wheezy infants (8-26 months) were studied.
- Lung function was assessed during acute exacerbations and asymptomatic periods using the raised volume rapid thoracic compression technique (RVRTC) for FEV(t) and tidal volume rapid thoracic compression technique (TVRTC) for VmaxFRC.
- Subjective overall health assessments were obtained from the study physician and the infant's mother.
Main Results:
- Mean FEV(t) (FEV(0.5) and FEV(0.75)) were significantly lower during exacerbations compared to asymptomatic periods.
- Mean VmaxFRC did not show significant differences between exacerbation and asymptomatic periods.
- FEV(t) measurements correlated well with the study physician's overall health assessment, but not with the mother's assessment.
Conclusions:
- Objective FEV(t) measurements obtained via RVRTC correlate effectively with physician-based health assessments in infants.
- VmaxFRC measurements in the tidal volume range showed less correlation with subjective health assessments.
- The RVRTC technique is a feasible and reliable method for assessing and monitoring obstructive lung disease in infants.
Objectives:
The aim of this study was to compare subjective measures (overall health assessment both by the study physician and the child's mother) with objective measurements of forced expiratory volumes (FEV(t)) and maximal flow at functional residual capacity V(max)FRC) in recurrently wheezy infants.
Methods:
Sixteen wheezy infants (12 boys) aged 8-26 months were studied. A clinical assessment at visit 1 was followed by the run-in period during which day- and nighttime asthma symptom scores were obtained. The actual study period consisted of 2 visits when patient's lung function was assessed. The first of which was during an acute exacerbation (visit 2), while the second was when the infant was asymptomatic (visit 3). FEV(t) were obtained by the raised volume rapid thoracic compression technique (RVRTC) and V(max)FRC by the tidal volume rapid thoracic compression technique (TVRTC).
Results:
Mean FEV(t) but not mean V(max)FRC were significantly lower at visit 2 compared to visit 3 (FEV(0.5): p = 0.005, and FEV(0.75): p = 0.002; V(max)FRC: p = 0.15) and correlated well with overall health assessment by the study physician (FEV(0.5): r = 0.82, and FEV(0.75): r = 0.84), but not with the overall health assessment by the mother.
Conclusions:
We have shown in the present study that objective measurements of FEV(t) from a raised lung volume correlate well with the overall health assessment by the study physician; this was in contrast to measurements of V(max)FRC in the tidal volume range. We therefore conclude that the RVRTC technique is a feasible method to assess and monitor obstructive lung disease in infancy.