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Sensitivity of Bronchial Responsiveness Measurements in Young Infants^*

^* From the Danish Pediatric Asthma Center (Drs. Loland, Buchvald, Halkjær, Anhøj, and Bisgaard), Department of Pediatrics, Copenhagen University Hospital, Hellerup, Denmark; Respiratory Medicine (Dr. Hall), Princess Margaret Hospital for Children and School of Paediatric and Child Health, University of Western Australia, Perth, WA, Australia; Statistical Department (Dr. Persson), Astra-Zeneca R&D Lund, Lund, Sweden; and Department of Epidemiology Research (Dr. Krause), Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen, Denmark.

Correspondence to: Hans Bisgaard, MD, DMSci, Danish Pediatric Asthma Center, Department of Pediatrics, Copenhagen University Hospital, Gentofte, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark; e-mail: Bisgaard{at}copsac.dk

Abstract

Objectives: There is limited evidence on the preferred methods for evaluating lung function in infancy. The objective of this study was to compare sensitivity and repeatability of indexes of lung function in young infants during induced airway obstruction.

Methods: The study population consisted of 402 infants (median age, 6 weeks). Forced flow-volume measurements were obtained by the raised volume rapid thoracoabdominal compression technique and were compared with indexes of tidal breathing, measurements of transcutaneous oxygen (PtcO₂), and auscultation during methacholine challenge testing.

Results: PtcO₂ was the most sensitive parameter to detect increasing airway obstruction during methacholine challenge, followed by forced expiratory volume at 0.5 s (FEV_0.5). Both were superior to other indexes of forced spirometry as well as tidal breathing indexes and auscultation. Coefficients of variations for PtcO₂ and FEV_0.5 were 4% and 7%, respectively.

Conclusions: PtcO₂ and FEV_0.5 are the most sensitive parameters for measurement of bronchial responsiveness in young infants. Measurements of baseline lung function should preferably be made using FEV_0.5. Measurements of bronchial responsiveness are best assessed using PtcO₂, which may be performed in nonsedated infants and improve feasibility of future studies on lung function in infancy.

Key Words: bronchial provocation tests • reproducibility of results • respiratory function tests

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