Reduced lung function both before bronchiolitis and at 11 years

S W Turner1, S Young, L I Landau

  • 1University Department of Paediatrics, Princess Margaret Hospital for Children, Perth, Australia. s.w.turner@ncl.ac.uk

Insights

Bronchiolitis in infancy is linked to reduced lung function (V'maxFRC) and increased wheezing in childhood. However, this lung function deficit appears to stem from pre-existing conditions rather than the illness itself.

Area of Science:

  • Pediatric Respiratory Medicine
  • Pulmonology
  • Epidemiology

Background:

  • Previous research indicated a link between reduced maximal expiratory flow at functional residual capacity (V'maxFRC) and bronchiolitis.
  • A hypothesis was formed that bronchiolitis would lead to diminished lung function and heightened respiratory symptoms in children.

Purpose of the Study:

  • To investigate the long-term effects of bronchiolitis on childhood lung function and respiratory symptoms.
  • To determine if bronchiolitis causes persistent lung function deficits or exacerbates pre-existing conditions.

Main Methods:

  • Maximal expiratory flow at functional residual capacity (V'maxFRC) was measured at one month of age.
  • Children diagnosed with bronchiolitis were prospectively identified and followed.
  • Annual respiratory symptom questionnaires were administered from ages 3 to 6.
  • A comprehensive assessment at 11 years included questionnaires, lung function tests, airway responsiveness to histamine (AR), and skin prick testing.

Main Results:

  • Children with a history of bronchiolitis exhibited increased viral-induced wheeze at ages 3 and 5.
  • At 11 years, individuals with prior bronchiolitis showed reduced mean z scores for % V'maxFRC and % FEF(25-75) compared to controls.
  • No significant differences were observed between groups at age 11 for FEV(1), FVC, PEF, AR, atopy, wheeze, or diagnosed asthma.

Conclusions:

  • Reduced lung function is evident both before and after bronchiolitis, with comparable levels of deficit.
  • The findings suggest that the wheeze and reduced lung function observed post-bronchiolitis are primarily attributable to premorbid lung function rather than the infection itself.
Abstract

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