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[Clinical application of tidal breathing lung function test in 1-4 years old children with wheezing diseases]
Wen Han1, Yong Xie, Shu-Ying Ren
1Department of Pediarics, Central Hospital of Karamay, Karamay, Xinjiang 834000, China. halen834000@sina.com.
Insights
Tidal breathing lung function tests reveal obstructive ventilatory disorder in young children with wheezing. While the bronchial dilation test shows limited sensitivity for diagnosing asthma, it aids in identifying severe airway obstruction in this age group.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Testing
Context:
- Wheezing diseases are common in children aged 1-4 years.
- Accurate diagnosis of pediatric respiratory conditions can be challenging.
- Lung function testing provides objective measures of respiratory health.
Purpose:
- To assess the clinical significance of tidal breathing lung function tests in children aged 1-4 with wheezing diseases.
- To evaluate the utility of tidal breathing flow volume parameters and bronchial dilation tests in diagnosing asthma and other wheezing conditions.
- To determine the effectiveness of bronchial dilation testing in identifying reversible airway obstruction.
Summary:
- 141 children with wheezing diseases (asthma, asthmatic bronchitis, bronchopneumonia) and 30 controls underwent tidal breathing lung function tests.
- Obstructive ventilatory disorder was identified in 65% of children with wheezing.
- The bronchial dilation test showed moderate specificity (84%) but limited sensitivity (47%) for diagnosing asthma, though it proved valuable for detecting severe airway obstruction.
Impact:
- Tidal breathing lung function tests are valuable for identifying obstructive ventilatory disorders in young children with wheezing.
- The bronchial dilation test, while not highly sensitive for asthma diagnosis in this age group, can indicate reversible airway obstruction.
- Findings suggest the test's utility in identifying children with significant airway obstruction, potentially aiding in management decisions.
Objective:
To study the clinical significance of tidal breathing lung function test in 1-4 years old children with wheezing diseases.
Methods:
A total of 141 1-4 years old children with wheezing diseases were enrolled as the observed groups (41 cases of asthma, 54 cases of asthmatic bronchitis, and 46 cases of bronchopneumonia). Thirty children without respiratory diseases were enrolled as the control group. All the recruits underwent tidal breathing lung function test. The observed groups underwent bronchial dilation test, and tidal breathing flow volume (TBFV) parameters were evaluated before and after bronchial dilation test.
Results:
The observed groups showed obstructive ventilatory disorder (65%) according to the TBFV loop, and their ratio of time to peak tidal expiratory flow (TPTEF) to total expiratory time (TE) and ratio of volume to peak expiratory flow (VPEF) to total expiratory volume (VE) were significantly lower than in the control group (P<0.05). The asthma subgroup had significantly improved TPTEF/TE and VPEF/VE after bronchial dilation test (P<0.05). Taking an improvement rate of ≥ 15% either for TPTEF/TE or for VPEF/VE as an indicator of positive bronchial dilation test, the bronchial dilation test had a sensitivity of 47% and a specificity of 84% in diagnosing asthma in 1-4 years old children. The positive rate was 28% among the children in the asthma subgroup with an TPTEF/TE ratio of ≥ 23% before bronchial dilation test, versus 65% in those with an TPTEF/TE ratio of <23%.
Conclusions:
Obstructive ventilatory disorder is the main impairment of tidal breathing lung function in 1-4 years old children with wheezing diseases. Tidal breathing bronchial dilation test can reflect a reversal of airway obstruction to a certain extent. The sensitivity of bronchial dilation test for the diagnosis of asthma is not satisfactory in 1-4 years old children with wheezing diseases, but this test has a relatively high diagnostic value in children with severe airway obstruction.
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