摘要
Sixty-four pediatric patients with asthma exacerbation were studied. The c</span><span style="font-family:""><span style="font-family:Verdana;">hildren were subjected to respiratory resistance evaluation using the Airflow Perturbation Device (APD) and spirometry evaluation. They were then adminis</span><span style="font-family:Verdana;">tered albuterol and 15 minutes later the APD and spirometry evaluations w</span><span style="font-family:Verdana;">ere repeated. Eleven of the children could not perform spirometry. The APD re</span><span style="font-family:Verdana;">sults demonstrated that respiratory resistance of the patients decreased by a</span><span style="font-family:Verdana;">bout 20%, indicating that the APD could detect the expected response to bronchodilator. However, no similar conclusion could be made with the spirometry parameters (</span><span style="font-family:Verdana;">FVC, FEV1, FEV1/FVC, and FEF25% - 75%) performed on the same patients. The differences on the spirometry parameters did not change </span><span style="font-family:Verdana;">significantly before and after bronchodilator administration. Furthermore, th</span><span style="font-family:Verdana;">ese differences were negligibly increased or decreased for some with no consistency between the FVC, FEV1, FEV1/FVC, and FEF25% - 75%. Even though all the children were clinically improved after albuterol administration and discharged home, this could not be demonstrated by spirometry data. This study validates previous reports that spirometry is not a reliable pulmonary diagnostic tool for young children, as spirometry is highly effort-dependent and requires a substantial degree of patient cooperation. APD on the other hand is a reliable, simple, effortless diagnostic tool that can be utilized in evaluation and management of children with asthma symptoms and exacerbation.
Sixty-four pediatric patients with asthma exacerbation were studied. The c</span><span style="font-family:""><span style="font-family:Verdana;">hildren were subjected to respiratory resistance evaluation using the Airflow Perturbation Device (APD) and spirometry evaluation. They were then adminis</span><span style="font-family:Verdana;">tered albuterol and 15 minutes later the APD and spirometry evaluations w</span><span style="font-family:Verdana;">ere repeated. Eleven of the children could not perform spirometry. The APD re</span><span style="font-family:Verdana;">sults demonstrated that respiratory resistance of the patients decreased by a</span><span style="font-family:Verdana;">bout 20%, indicating that the APD could detect the expected response to bronchodilator. However, no similar conclusion could be made with the spirometry parameters (</span><span style="font-family:Verdana;">FVC, FEV1, FEV1/FVC, and FEF25% - 75%) performed on the same patients. The differences on the spirometry parameters did not change </span><span style="font-family:Verdana;">significantly before and after bronchodilator administration. Furthermore, th</span><span style="font-family:Verdana;">ese differences were negligibly increased or decreased for some with no consistency between the FVC, FEV1, FEV1/FVC, and FEF25% - 75%. Even though all the children were clinically improved after albuterol administration and discharged home, this could not be demonstrated by spirometry data. This study validates previous reports that spirometry is not a reliable pulmonary diagnostic tool for young children, as spirometry is highly effort-dependent and requires a substantial degree of patient cooperation. APD on the other hand is a reliable, simple, effortless diagnostic tool that can be utilized in evaluation and management of children with asthma symptoms and exacerbation.
作者
Maria V. Bautista
Jafar Vossoughi
Arthur T. Johnson
Martin Keszler
Maria V. Bautista;Jafar Vossoughi;Arthur T. Johnson;Martin Keszler(Division of Pediatric Pulmonary and Sleep Medicine, Medstar Georgetown University Hospital, Wisconsin Ave NW, Washington, DC, USA;ESRA, Prospect Point Ct, Brookeville, MD, USA;Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA;Department of Pediatrics, Alpert Medical School of Brown University, Women and Infants Hospital of Rhode Island, Provi-dence, RI, USA)
