0
Clinical Investigations: ASTHMA |

Evaluation of the Magnitude of the Bronchodilator Response in Children and Adolescents With Asthma*

Maria Helena Bussamra, MD; Alberto Cukier, MD, FCCP; Rafael Stelmach, MD; Joaquim Carlos Rodrigues, MD
Author and Funding Information

*From Unidade de Pneumologia do Instituto da Criança (Drs. Bussamra and Rodrigues), University of São Paulo Medical School; and Pulmonary Division (Drs. Cukier and Stelmach), Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.

Correspondence to: Maria Helena Bussamra, MD, Rua Girassol, 464 ap52 São Paulo, SP, Brazil; CEP 05433001; e-mail: nena.ferreira@uol.com.br



Chest. 2005;127(2):530-535. doi:10.1378/chest.127.2.530
Text Size: A A A
Published online

Study objective: Bronchodilator response criteria have been determined in adults; however, data applicable to children and adolescents are scarce. We measured pulmonary function in asthmatic patients to determine the bronchodilator response.

Design: A blind study.

Setting: Outpatient clinic of Pneumology Unit, Instituto da Criança and Center of Asthma Care and Research, University Hospital, University of São Paulo Medical School.

Patients: Sixty patients aged 6 to 20 years (median, 12 years).

Interventions: Spirometry and plethysmography were performed before and after blind placebo and bronchodilator inhalation (400 μg salbutamol by metered-dose inhaler).

Measurements and results: Approximately 90% of the patients had mild-to-moderate persistent asthma. The mean FEV1 at baseline was 79.6% of the predicted value. Distribution of variations of the different pulmonary function parameters was analyzed after placebo inhalation. The 95th percentile was adopted as a criterion for a significant bronchodilator response. After the bronchodilator test, the patients were classified based on criteria derived from the placebo inhalation and the American Thoracic Society guidelines. Parameters established as cutoff values were 265 mL, 14.2% and 10% FEV1 expressed as absolute volume, percentage compared with that at baseline and percentage of the predicted value, respectively, and 55% specific airway conductance (sGaw) expressed as a percentage compared with that at baseline. Based on the spirometric data, 37 patients (61%) had reversibility of obstruction, while 48 patients (80%) were classified as responders based on the analysis of variations in sGaw. The classifications based on variations in FEV1 expressed as absolute volume and percentage of the predicted value showed a substantial correlation with the international classification.

Conclusions: The cutoff values established for the assessment of the bronchodilator response in the present population agree with those reported in the literature. sGaw was the most sensitive parameter for the identification of changes in airway caliber.


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Muscarinic Receptor Antagonists. Handb Exp Pharmacol Published online Oct 28, 2016;
Leukotriene Receptor Antagonists and Antiallergy Drugs. Handb Exp Pharmacol Published online Nov 09, 2016;
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543