SELECTED ARTICLES FROM THE RECENT LITERATURE 2007

November 5, 2007

A simplified exercise challenge to detect asthma in the 3-6 year old

Summary
The exercise challenge test (ECT) is a common tool to assess exercise-induced airway narrowing (EIAN) and asthma but has not been standardized in young children. The authors recruited 65 children (age range, 3-6 years old); 30 children with asthma (group A) and 25 children with prolonged cough (group B). A 6-min, controlled, free-run test were performed in mild dry climate (mean relative humidity of 30-40%, 22-28°C) while wearing a portable mobile pulse oxymeter. The authors found that controlled free-run ECT is suitable for young children, but that the running duration is limited by age (4.8 + 0.8 min). FEV0.5 was a better index (34 positive test and 31 of these children had wheezing and/or prolonged expiration, 26 from group A and 8 from group B) than FEV1 (15 positive test). Only 24 children had sufficient PEFR changes for positive test. The authors proposed that the association of wheezing and/or prolonged expiration may help in defining EINA in early childhood in the absence of a spirometer.

Editor's Comments
The article describes a safe way to conduct ECT in young children using a portable oxymeter monitoring device and customized duration of free-run. By using FEV0.5 as an index, the sensitivity of the test to detect asthma was markedly increased. The findings of the study add to the diagnostic tools for childhood asthma.

Reference
Vilozni D. et al. Chest 2007; 132:497-503

Submitted by Dr. Betty Lew

 

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