Commentary

Bronchodilation test and its clinical application in children

  • Hao ZHANG ,
  • Yanxia CHI
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  • 1. Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
    2. Fujian Children's Hospital / Fujian Branch of Shanghai Children's Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350014, Fujian, China

Received date: 2023-03-20

  Online published: 2023-05-10

Abstract

Bronchodilation test (BDT) is a method to detect the reversibility of spastic airway, which is mainly used in the diagnosis, differential diagnosis, treatment and follow-up of wheezing diseases. As awareness of the importance of the bronchodilatation test has increased, its clinical use has rapidly increased. Recently, a large number of researches both nationally and internationally have focued on how to interpret the results in clinical and define the positive thresholds. The purpose of this paper is to explore new standards and opinions, sort out the idea and make recommendations that are suitable for Chinese children.

Cite this article

Hao ZHANG , Yanxia CHI . Bronchodilation test and its clinical application in children[J]. Journal of Clinical Pediatrics, 2023 , 41(5) : 321 -327 . DOI: 10.12372/jcp.2023.23e0206

References

[1] 中华医学会呼吸病学分会肺功能专业组. 肺功能检查指南(第四部分)——支气管舒张试验[J]. 中华结核和呼吸杂志, 2014, 37(9): 655-658.
[2] 中华医学会儿科学分会呼吸学组肺功能协作组, 中华实用儿科临床杂志编辑委员会. 儿童肺功能系列指南(五): 支气管舒张试验[J]. 中华实用儿科临床杂志, 2017, 32(1): 17-21.
[3] 中华医学会儿科分会呼吸学组, 中华儿科杂志编辑委员会. 儿童支气管哮喘诊断与防治指南[J]. 中华儿科杂志, 2016, 54(3): 167-181.
[4] 中华医学会儿科学分会呼吸学组肺功能协作组, 中华实用儿科临床杂志编辑委员会. 儿童肺功能系列指南(三): 脉冲振荡[J]. 中华实用儿科临床杂志, 2016, 31(11): 821-825.
[5] King GG, Bates J, Berger KI, et al. Technical standards for respiratory oscillometry[J]. Eur Respir J, 2020, 55(2): 1900753.
[6] Kelly VJ, Brown NJ, Sands SA, et al. Effect of airway smooth muscle tone on airway distensibility measured by the forced oscillation technique in adults with asthma[J]. J Appl Physiol (1985), 2012, 112(9): 1494-1503.
[7] Barnas GM, Sprung J, Craft TM, et al. Effect of lung volume on lung resistance and elastance in awake subjects measured during sinusoidal forcing[J]. Anesthesiology, 1993, 78(6): 1082-1090.
[8] Thamrin C, Gangell C, Kusel M, et al. Expression of bronchodilator response using forced oscillation technique measurements: absolute versus relative[J]. Eur Respir J, 2010, 36(1): 212-213.
[9] Thamrin C, Gangell CL, Udomittipong K, et al. Assessment of bronchodilator responsiveness in preschool children using forced oscillations[J]. Thorax, 2007, 62(9): 814-819.
[10] Oostveen E, Dom S, Desager K, et al. Lung function and bronchodilator response in 4-year-old children with different wheezing phenotypes[J]. Eur Respir J, 2010, 35(4): 865-872.
[11] Calogero C, Parri N, Baccini A, et al. Respiratory impedance and bronchodilator response in healthy Italian preschool children[J]. Pediatr Pulmonol, 2010, 45(11): 1086-1094.
[12] Harrison J, Gibson AM, Johnson K, et al. Lung function in preschool children with a history of wheezing measured by forced oscillation and plethysmographic specific airway resistance[J]. Pediatr Pulmonol, 2010, 45(11): 1049-1056.
[13] Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests[J]. Eur Respir J, 2005, 26(5): 948-968.
[14] Kroegel C. Global Initiative for asthma management and prevention--GINA 2006[J]. Pneumologie, 2007, 61(5): 295-304.
[15] 中华医学会儿科学会呼吸学组, 中华儿科杂志编辑委员会. 儿童支气管哮喘诊断与防治指南[J]. 中华儿科杂志, 2008, 46(10): 745-753.
[16] Galant SP, Morphew T, Amaro S, et al. Value of the bronchodilator response in assessing controller na?ve asthmatic children[J]. J Pediatr, 2007, 151(5): 457-662.
[17] Tse SM, Gold DR, Sordillo JE, et al. Diagnostic accuracy of the bronchodilator response in children[J]. J Allergy Clin Immunol, 2013, 132(3): 554-559.
[18] Kang XH, Wang W, Cao L. A clinical study to determine the threshold of bronchodilator response for diagnosing asthma in Chinese children[J]. World J Pediatr, 2019, 15(6): 559-564.
[19] Stanojevic S, Kaminsky DA, Miller MR, et al. ERS/ATS technical standard on interpretive strategies for routine lung function tests[J]. Eur Respir J, 2022, 60(1): 2101499.
[20] Brand PL, Quanjer PH, Postma DS, et al. Interpretation of bronchodilator response in patients with obstructive airways disease. The Dutch Chronic Non-Specific Lung Disease (CNSLD) Study Group[J]. Thorax, 1992, 47(6): 429-436.
[21] Quanjer PH, Ruppel GL, Langhammer A, et al. Bronchodilator response in FVC is larger and more relevant than in FEV1 in severe airflow obstruction[J]. Chest, 2017, 151(5): 1088-1098.
[22] Tan WC, Vollmer WM, Lamprecht B, et al. Group BCR. Worldwide patterns of bronchodilator responsiveness: results from the Burden of Obstructive Lung Disease study[J]. Thorax, 2012, 67(8): 718-726.
[23] Ward H, Cooper BG, Miller MR. Improved criterion for assessing lung function reversibility[J]. Chest, 2015, 148(4): 877-886.
[24] Koga T, Kamimura T, Oshita Y, et al. Determinants of bronchodilator responsiveness in patients with controlled asthma[J]. J Asthma, 2006, 43(1): 71-74.
[25] Burity EF, Pereira CA, Jones MH, et al. Bronchodilator response cut-off points and FEV0.75 reference values for spirometry in preschoolers[J]. J Bras Pneumol, 2016, 42(5): 326-332.
[26] Chen C, Jian W, Gao Y, et al. Early COPD patients with lung hyperinflation associated with poorer lung function but better bronchodilator responsiveness[J]. Int J Chron Obstruct Pulmon Dis, 2016, 11: 2519-2526.
[27] Lee JS, Huh JW, Chae EJ, et al. Response patterns to bronchodilator and quantitative computed tomography in chronic obstructive pulmonary disease[J]. Clin Physiol Funct Imaging, 2012, 32(1): 12-18.
[28] Song TW, Kim KW, Kim ES, et al. Utility of impulse oscillometry in young children with asthma[J]. Pediatr Allergy Immunol, 2008, 19(8): 763-768.
[29] Sheen YH, Jee HM, Ha EK, et al. Impulse oscillometry and spirometry exhibit different features of lung function in bronchodilation[J]. J Asthma, 2018, 55(12): 1343-1351.
[30] Batmaz SB, Kuyucu S, Ar?koglu T, et al. Impulse oscillometry in acute and stable asthmatic children: a comparison with spirometry[J]. J Asthma, 2016, 53(2): 179-186.
[31] Shin YH, Jang SJ, Yoon JW, et al. Oscillometric and spirometric bronchodilator response in preschool children with and without asthma[J]. Can Respir J, 2012, 19(4): 273-277.
[32] Rao DR, Gaffin JM, Baxi SN, et al. The utility of forced expiratory flow between 25% and 75% of vital capacity in predicting childhood asthma morbidity and severity[J]. J Asthma, 2012, 49(6): 586-592.
[33] Galant SP, Morphew T, Guijon O, et al. The bronchodilator response as a predictor of inhaled corticosteroid responsiveness in asthmatic children with normal baseline spirometry[J]. Pediatr Pulmonol, 2014, 49(12): 1162-1169.
[34] Fernandes AL, Amorim MM, Caetano LB, et al. Bronchodilator response as a hallmark of uncontrolled asthma: a randomised clinical trial[J]. J Asthma, 2014, 51(4): 405-410.
[35] 中国医药教育协会儿科专业委员会, 中华医学会儿科学分会呼吸学组, 中华医学会儿科学分会新生儿学组, 等. 支气管肺发育不良的儿童期管理专家共识[J]. 中华实用儿科临床杂志, 2022, 37(20): 1527-1538.
[36] Simpson SJ, Turkovic L, Wilson AC, et al. Lung function trajectories throughout childhood in survivors of very preterm birth: a longitudinal cohort study[J]. Lancet Child Adolesc Health, 2018, 2(5): 350-359.
[37] Islam JY, Keller RL, Aschner JL, et al. Understanding the short- and long-term respiratory outcomes of prematurity and bronchopulmonary dysplasia[J]. Am J Respir Crit Care Med, 2015, 192(2): 134-156.
[38] Duijts L, van Meel ER, Moschino L, et al. European Respiratory Society guideline on long-term management of children with bronchopulmonary dysplasia[J]. Eur Respir J, 2020, 55(1): 1900788.
[39] Doyle LW, Andersson S, Bush A, et al. Expiratory airflow in late adolescence and early adulthood in individuals born very preterm or with very low birthweight compared with controls born at term or with normal birthweight: a meta-analysis of individual participant data[J]. Lancet Respir Med, 2019, 7(8): 677-686.
[40] Barker AF, Bergeron A, Rom WN, et al. Obliterative bronchiolitis[J]. N Engl J Med, 2014, 370(19): 1820-1828.
[41] Jerkic S P, Brinkmann F, Calder A, et al. Postinfectious bronchiolitis obliterans in children: diagnostic workup and therapeutic options: a workshop report[J]. Can Respir J, 2020, 2020: 5852827.
[42] 仲玉强. 肥胖对支气管哮喘患儿肺功能和炎性因子的影响[J]. 中华实用儿科临床杂志, 2016, 31(21): 1668-1670.
[43] Barjaktarevic I, Kaner R, Buhr RG, et al. Bronchodilator responsiveness or reversibility in asthma and COPD - a need for clarity[J]. Int J Chron Obstruct Pulmon Dis, 2018, 13: 3511-3513.
[44] Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests[J]. Eur Respir J, 2005, 26(5): 948-968.
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