Respiratory impedance and response to salbutamol in asthmatic Vietnamese children.

There is a high incidence of pediatric asthma in Vietnam, but little lung function data are available. The aim of the study was to compare respiratory resistance (Rrs), reactance (Xrs), and responses to salbutamol between asthmatic and healthy primary school children in Hanoi. Because respiratory mechanics vary along the breathing cycle, measurements were assessed separately in inspiration (Rrsi, Xrsi) and expiration (Rrse, Xrse).Inpatients with doctor-diagnosed asthma were measured 2-3 days following admission using the forced oscillation technique (FOT) at a single frequency (8 Hz). Z-scores and responses to salbutamol were compared between 102 asthmatics and 98 controls, and accuracy of group classification by FOT parameters was assessed by Youden index, an indicator to the proportion of subjects correctly classified in each group.In asthmatics versus controls, Rrsi-but not Rrse-was significantly larger and both Xrsi and Xrse were significantly more negative (P < 0.01). Both Rrs and Xrs responses to salbutamol were significantly larger in asthmatics than controls (P < 0.001). Youden indexes indicated response to salbutamol generally had better diagnostic values than Z-scores and was best discriminative first with Rrsi, then with Xrse.It is concluded that different FOT characteristics may be described in asthmatic and healthy Vietnamese children. The diagnostic value of each parameter depends upon the breathing cycle. Most useful in practice probably is the response to salbutamol measured by Rrsi.

Respiratory impedance and response to salbutamol in healthy Vietnamese children.

A high incidence of childhood asthma has been reported in Ha Noi, Viet Nam, indicating a need to document lung function in these children. The degree of airway obstruction and reversibility may be evaluated from the forced oscillation assessment of respiratory resistance to reactance (Rrs, Xrs). Appropriate controls are necessary for a proper interpretation of patients. The aim of the study was to provide reference values on Rrs and Xrs and response to salbutamol in healthy Vietnamese children. One hundred seventy-five children aged 6-11 year recruited from one public school in Ha Noi were studied. Measurements were obtained at baseline and after 200 microg inhaled salbutamol. Significant correlations were disclosed between Rrs or Xrs and standing height (P < 0.0001). Salbutamol significantly decreased Rrs (from 7.1 +/- 1.9 hPa.sec/L to 6.2 +/- 1.8 hPa sec/L, P < 0.0001) and increased Xrs (from -1.22 +/- 0.64 to -0.91 +/- 0.61 hPa.sec/L, P < 0.0001). Rrs response to salbutamol lower limit of 95% confidence interval was -38% from baseline Rrs and, Xrs upper limit was +16% from baseline impedance. It is concluded that reference values for respiratory impedance (Zrs) and thresholds for clinically relevant response to bronchodilator are provided in primary school Vietnamese children. A smaller slope for the observed Rrs-body height relationship is suggested with reference to relevant studies in healthy Caucasians.