Related Experiment Video
Updated: Dec 4, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Lung function trajectories and bronchial hyperresponsiveness during childhood following severe RSV bronchiolitis in
Maleewan Kitcharoensakkul1, Leonard B Bacharier1, Toni L Schweiger2
1The Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO, USA.
Insights
Severe respiratory syncytial virus (RSV) bronchiolitis in infancy impacts lung function long-term. Lung function declined in childhood, but bronchial hyperreactivity lessened with age in a study of RSV-exposed children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Epidemiology
Background:
- Infants hospitalized with severe respiratory syncytial virus (RSV) bronchiolitis face higher risks of developing asthma and reduced lung function later in life.
- Limited research exists on the longitudinal changes in lung function and bronchial hyperreactivity from early to late childhood following RSV bronchiolitis.
Purpose of the Study:
- To investigate the longitudinal changes in lung function and bronchial hyperreactivity in children hospitalized for RSV bronchiolitis during infancy.
- To identify factors associated with declining lung function in later childhood.
Main Methods:
- A prospective cohort study followed 206 infants with their first RSV-confirmed bronchiolitis episode.
- Spirometry was performed at least twice between ages 5-16 years for 122 children.
- Methacholine bronchoprovocation tests were conducted at ages 7 and 12 years for subsets of the cohort.
Main Results:
- Significant longitudinal declines in pre- and post-bronchodilator FEV1, FVC, and FEV1/FVC z-scores were observed from age 5 to 10-16 years (P < .0001).
- Declined lung function was associated with male gender, asthma diagnosis, and allergic sensitization.
- The prevalence of abnormal bronchial hyperreactivity decreased from 96% at age 7 to 78% at age 12 (P = .0003).
Conclusions:
- Severe RSV bronchiolitis is associated with significant longitudinal changes in lung function during childhood.
- Bronchial hyperreactivity is prevalent in children post-RSV bronchiolitis but tends to decrease in late childhood.
- Study limitations include significant dropout rates, lack of a control group, and limited post-bronchodilator measurements.
Background:
Children with severe respiratory syncytial virus (RSV) bronchiolitis in infancy have increased risks of asthma and reduced lung function in later life. There are limited studies on the longitudinal changes of lung function and bronchial hyperreactivity from early to late childhood in infants hospitalized for RSV bronchiolitis.
Methods:
In a prospective cohort of 206 children with their first episode of RSV-confirmed bronchiolitis in the first year of life, 122 had spirometry performed at least twice between 5-16 years of age. Methacholine bronchoprovocation was available in 127 and 79 children at 7 and 12 years of age, respectively. Longitudinal changes in FEV1 , FVC, and FEV1 /FVC z-scores and methacholine PC20 were analyzed.
Results:
55% of the study cohort (N = 122) were male, and 55% were Caucasian. During follow-up, longitudinal changes in z-scores for pre- and post-bronchodilator FEV1 (P < .0001) FVC (P < .0001) and FEV1 /FVC (P < .0001 for pre- and 0.007 for post-bronchodilator) from age 5 to 10-16 years were observed. Declined lung function in late childhood was significantly associated with gender, physician diagnosis of asthma, and allergic sensitization. PC20 geometric mean increased from 0.28 mg/mL at 7 years to 0.53 mg/mL at 12 years of age, and the frequency of abnormal bronchial hyperreactivity decreased from 96% to 78% (P = .0003).
Conclusions:
Following severe RSV bronchiolitis, there appear to be significant longitudinal changes in pre- and post-bronchodilator lung function during childhood. The study has several limitations including significant dropouts and the lack of a control group and post-bronchodilator measurements. Bronchial hyperreactivity is common in children following severe RSV bronchiolitis; however, it appears to decrease as they enter late childhood.
More Related Videos
Related Concept Videos
01:17Pulmonary Cycle: Exhalation
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:23The Bronchial Tree
The trachea, commonly known as the windpipe, is a tube that connects the larynx (voice box) to the bronchi. At a point called the carina, it bifurcates into two primary bronchi. The right primary bronchus is wider, shorter, and more vertical than the left primary...
01:05Breathing
01:29Asthma-I: Introduction
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.