avaliação da função respiratória em função dos factores de risco para asma em crianças com sibilância recorrente

Translated title of the contribution: Lung function and clinical risk factors for asthma in infants and young children with recurrent wheeze

Luís Miguel Borrego, Janet Stocks, Paula Leiria-Pinto, Isabel Peralta, Ana Margarida Romeira, José Rosado-Pinto, Ah Fong Hoo

Research output: Contribution to journalArticle

Abstract

Background: Although several risk factors for bronchial asthma have been identified in infants and young children with recurrent wheeze, the relevance of assessing lung function in this group remains unclear. We assessed whether the respiratory function was impaired during the first 2 years of life in recurrently wheezy children, with and without clinical risk factors for bronchial asthma (i.e., parental asthma or personal history of eczema or, at least, two of the following: personal history of allergic rhinitis, wheezing without colds and eosinophil level > 4%), when compared with healthy controls. Methods: Forced expiratory flows and volumes in steroid naïve children, aged 8-20 months, with ≥ 3 episodes of physician-confirmed wheeze, and in healthy controls, were measured using the rapid thoraco-abdominal compression (RTC) and raised-volume rapid thoraco-abdominal compression (RVRTC) techniques. Results: Technically acceptable results were obtained in 50 wheezy children and 30 controls using the RTC technique, and in 44 wheezy children and 29 controls with the RVRTC technique. After adjustment for sex, age, body length at test and maternal smoking, significant reductions in Z-scores for FEV 0.5 (mean difference [95% CI]:-1.0 [-1.5;-0.5]), FEF 75 (-0.6 [-1.0;-0.2]) and FEF 25-75 (-0.8 [-1.2;-0.4]) were observed in those with recurrent wheeze when compared with controls. Wheezy children with high risk for asthma (n = 15) had significantly lower Z-scores for FVC (-0.7 [-1.4;-0.04]) and FEF 25-75 (-0.6 [-1.2;-0.1]) than those without such risk factors (n = 29). Conclusions: When compared to healthy controls, airway function is reduced in young children with recurrent wheeze, particularly those at high risk for subsequent asthma. These findings provide further evidence for associations between clinical risk factors for bronchial asthma and impaired respiratory function in early life. Prospective follow-up of these children may assess its predictive value for asthma in school age.

Original languagePortuguese
Pages (from-to)117-135
Number of pages19
JournalRevista Portuguesa de Imunoalergologia
Volume18
Issue number2
Publication statusPublished - 1 Mar 2010

Keywords

  • Asthma
  • Child
  • Infant
  • Respiratory function test
  • Wheezing

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