Wong Michael W H, Chien Lung-Chang, Bhammar Dharini M
Department of Kinesiology and Nutrition Sciences, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
Pediatr Rep. 2024 Jan 5;16(1):46-56. doi: 10.3390/pediatric16010005.
Children with asthma may have a reduced ventilatory capacity, which could lead to symptoms and early termination of a cardiopulmonary exercise test (CPET). The purpose of this study was to examine the effects of short-acting beta agonist (albuterol) administration on estimated ventilatory capacity in children with asthma.
Fifteen children (eleven boys, 10.6 ± 0.9 years) completed spirometry at baseline, after 180 µg of albuterol, and after the CPET in this cross-sectional study. Ventilatory capacity was calculated from forced vital capacity (FVC) and isovolume forced expiratory time from 25 to 75% of FVC (isoFET) as follows: FVC/2 × [60/(2 × isoFET)]. Differences in outcome variables between baseline, after albuterol administration, and after the CPET were detected with repeated measures mixed models with Bonferroni post hoc corrections.
Estimated ventilatory capacity was higher after albuterol (68.7 ± 21.2 L/min) and after the CPET (75.8 ± 25.6 L/min) when compared with baseline (60.9 ± 22.0 L/min; P = 0.003). Because forced vital capacity did not change, the increased ventilatory capacity was primarily due to a decrease in isoFET (i.e., an increase in mid-flows or isoFEF).
Albuterol administration could be considered prior to CPET for children with asthma with relatively well-preserved FEV values to increase ventilatory capacity pre-exercise and potentially avoid symptom-limited early termination of testing.
哮喘患儿的通气能力可能会降低,这可能导致症状出现并使心肺运动试验(CPET)提前终止。本研究的目的是探讨吸入短效β受体激动剂(沙丁胺醇)对哮喘患儿估计通气能力的影响。
在这项横断面研究中,15名儿童(11名男孩,10.6±0.9岁)在基线、吸入180μg沙丁胺醇后以及CPET后完成了肺功能测定。通气能力根据用力肺活量(FVC)和FVC 25%至75%的等容积用力呼气时间(isoFET)计算如下:FVC/2×[60/(2×isoFET)]。采用重复测量混合模型及Bonferroni事后校正,检测基线、吸入沙丁胺醇后和CPET后结局变量的差异。
与基线(60.9±22.0L/min)相比,吸入沙丁胺醇后(68.7±21.2L/min)和CPET后(75.8±25.6L/min)的估计通气能力更高(P=0.003)。由于用力肺活量未发生变化,通气能力增加主要是由于isoFET缩短(即,中期流速或等流量容积增加)。
对于FEV值相对保留较好的哮喘患儿,可在CPET前考虑吸入沙丁胺醇,以增加运动前的通气能力,并可能避免因症状限制而提前终止测试。