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Original ResearchASTHMAFeasibility of Repetitive Lung Function Measurements by Raised Volume Rapid Thoracoabdominal Compression During Methacholine Challenge in Young Infants
Section snippets
Materials and Methods
The study included infants from the COPSAC birth cohort study,2 which includes 411 infants of mothers with asthma, excluding infants with gestational age of < 36 weeks, congenital abnormality, systemic illness, or a history of mechanical ventilation or lower airway infection. Parents gave written informed consent, and the study was approved by the local ethics committee ([KF]01-289/96 and [KF]01-227/97) and the Danish Data Protection Agency (1996-1200-360).
Success Rate
Lung function tests were completed by 402 infants (median age, 6 weeks [quartiles, 5 to 8 weeks]; median height, 56 cm [quartiles, 54 to 58 cm]; and weight, 5 kg [quartiles, 4.5 to 5.5 kg]). The success rate was 99% for the measurement of baseline lung function and 79% for PD determined by FEV0.5 (Table 3); 72 infants failed repeat measurements of FEV0.5 due to technical reasons or insufficient sedation. The technical difficulties were primarily glottic closure or preterm inspiration during
Discussion
There is a clinical need for lung function measurement in early life similar to the well-established role of lung function measurements later in childhood. Information on lung function would be valuable in young infants with bronchopulmonary dysplasia, cystic fibroses, extreme prematurity, anatomic anomalies, and similar disorders. Likewise, research151617 into lung disorders in early life needs objective assessments of lung function. Methods for lung function measurements have been available
Conclusion
Based on this large series of standardized measurements of baseline lung function and determination of bronchial reactivity by RVRTC during methacholine challenge testing, we conclude that the methods are safe and feasible, yet the requirement for sedation restricts its use to research and selected clinical cases.
ACKNOWLEDGMENT
We thank the parents of the infants studied for their participation and technician Lena Vind for her help in data collection.
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2016, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Airway responsiveness was assessed by using a methacholine challenge test performed with a Wright nebulizer driven by air at 21 psi and a dynamic flow of 18 L/min starting with ab isotonic saline inhalation followed by 0.5 mg/mL methacholine, with subsequent doubling concentrations to a maximum of 64 mg/mL. The provocative dose of methacholine causing a 20% decrease in FEV1 from baseline (PD20) was the test outcome.22 Allergen-specific IgE levels were determined by using a screening method (ImmunoCAP, Phadiatop Infant; Pharmacia Diagnostics AB, Uppsala, Sweden) against the most common inhalant allergens in Denmark (cat, dog, horse, birch, timothy grass, mugwort, house dust mites, and molds).
Neonates with reduced neonatal lung function have systemic low-grade inflammation
2015, Journal of Allergy and Clinical ImmunologyPrenatal and postnatal genetic influence on lung function development
2014, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Maternal factors potentially influencing neonatal lung function included maternal sensitization determined by using specific IgE measurement (ImmunoCAP; Phadia AB, Uppsala, Sweden)20 on 0.35 kU/L or more to any common inhalant allergens,21 worsening of asthma during pregnancy, and similarity of genetic risk scores similar to childhood risk scores. All lung function measures were calibrated for body size and sex, as detailed earlier,4,17,18 and used as z scores. SNP allele dosages (taking into account imputation accuracy) were used, assuming additive genetic models.
This study was supported by Statens Sundhedsvidenskabelige Forskningsråd, Direktør Jakob Madsen & Hustru Olga Madsens Fond, Dagmar Marshalls Fond, and Dronning Louises Børnehospitals Forskningsfond.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.