Bronchodilator challenge test using the tidal rapid thoracoabdominal compression technique among infants aged 6-24 months with recurrent wheezing

ABSTRACT

BACKGROUND@#A definite diagnosis of asthma during infancy is difficult. Asthma Predictive Index (API) is used to predict asthma at school age, but does not determine who among these actually have asthma.@*OBJECTIVES@#This study aims to determine the bronchodilator response of infants with recurrent wheezing compared with normal control.@*METHODOLOGY@#This cross sectional study included asymptomatic subjects aged 6-24 months with history of recurrent wheezing and age/sex matched controls. After sedation with chloral hydrate (Odan) at 50-75 mg/kg, a bronchodilator challenge test was performed with single dose 400 mcg salbutamol (Ventolin) MDI inhalation delivered via a spacer (Philips Respironic OptiChamber Diamond). Baseline and 15 minutes after salbutamol inhalation Maximum Flow at Functional Residual Capacity (V‘maxFRC) were determined using MasterScreen Paed/BabyBody Option Squeeze version 8.0. ANOVA and Pearson chi-square were used for the statistical analysis of data.@*RESULTS@#Sixty-nine infants (23 previous wheezers and positive API, 23 previous wheezers with negative API and 23 controls) were included. There was a significant difference in the post bronchodilator challenge test V‘maxFRC between wheezers with positive API and controls (p= 0.047). There was no significant difference in other parameter among groups.@*CONCLUSION AND RECOMMENDATION@#Absolute values of V‘maxFRC post bronchodilator challenge using the Tidal Rapid Thoracoabdominal compression technique may be used to identify current asthma among asymptomatic infants with recurrent wheezing. Further studies with patient follow-up are recommended to assess response to treatment.