Study objective: Measuring bronchodilator (BD) response in school children by spirometry is an integral part of asthma diagnosis and assessment. However, the applicability of the spirometry criteria to preschool age is questionable. We measured changes in forced spirometry indices to determine their ability to detect BD-response in asthmatic preschool children. Patients and methods: Data of 288 children (aged 2.6–6.9y) were analyzed. Spirometry tests were carried out before and 15 minutes after BD-inhalation in 145 asthmatic children. Data was compared to that of 39 controls and to that after inhalations of saline (n=104 asthmatics)administrated similarly. An increase above 12% from baseline FEV1 after intervention was considered significant. Response of other spirometry indices were related to change in FEV1. Results: The mean (±SD) Post-BD elevation in FEV1 was 16.1+13.6%baseline. 81/145 (56%) asthmatic children increased their FEV1 greater than 12% after BD-inhalation. Other indices increased by 23.4±24.8%; 27.4±26.7 and 48.3±35.6% in FEV0.5, PEF and FEF25-75 respectively (n=69%,70%, and 74% of the group; p<0.001 for all). The response of the control group to bronchodilators or to Saline was negligence. Conclusions: Spirometry in preschool children can detect bronchodilator effect in asthmatic children similar to that in older populations. The best index to describe the response should be further explored. A larger prospective study comparing the bronchodilator effect in young healthy and asthmatic children is required to further support our results. The study was funded by the J. Baum foundation of the Israeli Lung Association, Tel Aviv, Israel.
Vilozni et al. (Thu,) studied this question.