Burman Janne, Lukkarinen Heikki, Elenius Varpu, Remes Sami, Kuusela Tom, Jartti Tuomas
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.
Department of Pediatrics, Turku University Hospital, Turku, Finland.
Clin Physiol Funct Imaging. 2018 Jul;38(4):718-720. doi: 10.1111/cpf.12458. Epub 2017 Aug 7.
In children, exercise-induced dyspnea is a common symptom that can be due to dysfunctional breathing. EVH test has bee used especially in elite athletes as bronchoprovocation test. Currently, there are only few studies on the EVH test. New research methods are required alongside the traditionally used tests especially due to dysfunctional breathing disorder.
The purpose of the "pilot study" was to study the usability of the EVH test with real time biofeedback in children of 10-16 years of age in the diagnostics of exercise-induced dyspnea.
Six 10-16-year-old teenagers with history of exercise-induced dyspnea and three healthy control subjects were selected for the study. A 6-minute EVH test with realtime biofeedback was performed on the patients and the diagnosis was confirmed on the basis of clinical findings and spirometry follow-up either as normal, asthma or dysfunctional breathing.
The study was successful in the patients. In the spirometry follow-up, three patients had bronchoconstriction (FEV1 decline over 10%), dysfunctional breathing condition was observed in three patients and three control patients experienced no symptoms. Only two DFB-patients didn't reach the target level of minute ventilation due to a clinical symptom (inspiratory stridor).
The EVH test was successful in the 10-16-year-old children having participated in the study and the test was well tolerated. Through the study, it was possible to provoke both dysfunctional breathing disorder and bronchoconstriction in the symptomatic patients. Based on the pilot study, EVH test seems to be usable in the diagnostics of pediatric exercise-induced dyspnea but larger studies are warranted to confirm our preliminary findings.
在儿童中,运动诱发的呼吸困难是一种常见症状,可能是由于呼吸功能障碍所致。呼气末组胺激发试验(EVH)尤其被用于精英运动员作为支气管激发试验。目前,关于EVH试验的研究较少。特别是由于呼吸功能障碍性疾病,除了传统使用的试验外,还需要新的研究方法。
“试点研究”的目的是研究在10 - 16岁儿童运动诱发呼吸困难的诊断中,实时生物反馈的EVH试验的可用性。
选择6名有运动诱发呼吸困难病史的10 - 16岁青少年和3名健康对照受试者进行研究。对患者进行了6分钟的实时生物反馈EVH试验,并根据临床发现和肺活量测定随访结果确诊为正常、哮喘或呼吸功能障碍。
该研究在患者中取得成功。在肺活量测定随访中,3例患者出现支气管收缩(FEV1下降超过10%),3例患者观察到呼吸功能障碍,3例对照患者未出现症状。只有2例功能障碍性呼吸疾病(DFB)患者因临床症状(吸气性喘鸣)未达到分钟通气量的目标水平。
EVH试验在参与研究的10 - 16岁儿童中取得成功,且耐受性良好。通过该研究,有可能在有症状的患者中诱发呼吸功能障碍性疾病和支气管收缩。基于试点研究,EVH试验似乎可用于小儿运动诱发呼吸困难的诊断,但需要更大规模的研究来证实我们的初步发现。