PT  - JOURNAL ARTICLE
AU  - Luciano Enrique Busi
AU  - Peter Sly
AU  - Ricardo Daniel Tourres
TI  - Assessing bronchodilator response (BDR) in preschool children using spirometry
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P3513
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P3513.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P3513.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Measuring bronchodilator response (BDR) can be a useful aid in the diagnosis and management of asthma in children; however information about the within-occasion (repeatability) and between-occasion (reproducibility) variability is necessary to interpret the results. In the present study we sought to determine the BDR repeatability and reproducibility in healthy preschoolers and in those with asthma. We recruited 519 healthy children from 7 randomly selected kindergartens and 201 asthmatics from the pulmonology clinic in Trelew, Argentina and performed spirometry according to ATS standards before and after salbutamol 400mcg or placebo (random allocation). The entire procedure was repeated within 8 weeks. The intra-occasion and inter-occasion coefficients of repeatability were calculated. All analyses were performed in SPSS 20.0. There were no significant differences between groups with respect to demographic and anthropometric data and exposition to environmental tobacco smoke. Asthmatic children showed greater BDR than healthy children in FEV0.75 (13.2% v 4.6%), FEV1 (10.3% v 4.3%) and FEF25-75 (33% v 10.2%) (all p<0.01). Based on our data in healthy children, the threshold for a positive BDR (mean difference±2SD) would be an increase of 14.4% for FEV0.75, 16.9% for FEV1 and 48.2% for FEF25-75. The area under the ROC curve for BDR-FEV0.75 was 0.698. We conclude that BDR assessed by spirometry is a reliable test to discriminate asthma in preschool children, taking into account the high variability of this test.