Diagnostic Value of Bronchial Hyperreactivity Using Chest Auscultation and Oxygen Saturation Measurement in Preschool Children with a History of Wheezing.
- Author:
Dong In SUH
1
;
Young YOO
;
Do Kyun KIM
;
Jinho YU
;
Hee KANG
;
Young Yull KOH
Author Information
1. Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea. kohyy@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Bronchial hyperreactivity;
Methacholine inhalation;
Chest auscultation;
Oxygen saturation measurement;
Respiratory rate;
Bronchial provocation tests;
Diagnostic value;
Receiver operating characteristic curve;
Preschool children
- MeSH:
Asthma;
Auscultation*;
Bronchial Hyperreactivity*;
Bronchial Provocation Tests;
Child;
Child, Preschool*;
Diagnosis;
Humans;
Methacholine Chloride;
Oxygen*;
Respiratory Rate;
Respiratory Sounds*;
ROC Curve;
Sensitivity and Specificity;
Thorax*
- From:Pediatric Allergy and Respiratory Disease
2004;14(2):133-141
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study aimed to evaluate the validity of chest auscultation and oxygen saturation measurement in the assessment of bronchial hyperreactivity to inhaled methacholine in preschool children who were thought to be asthmatic clinically. METHODS: Seventy-two children with a history of more than three wheezing episodes in the previous year were considered the asthma group and underwent methacholine bronchial challenges. Provocation concentration at wheezing (PCw), at 5% fall of oxygen saturation (PCSat), and at 50% increase in respiratory rate (PCRR) were determined in each subject. One hundred and eighteen children who have had less than two wheezing episodes in their life served as control group. RESULTS: The geometric means of PCw, PCSat, and PCRR of asthma group were significantly lower than those of the control group. The optimal cut-off level for PCw was 8 mg/mL, giving a sensitivity of 63% and a specificity of 78%. Corresponding values for PCSat and PCRR were 8 mg/mL (72%, 67%) and 16 mg/mL (49%, 86%), respectively. The area under the receiver operating characteristic (ROC) curve for PCw, PCSat, and PCRR were 0.80, 0.88, and 0.70 respectively. The discriminative capacity of PCSat as judged by ROC curve analysis exceed those of PCw and PCRR. CONCLUSION: These findings provide support for the use of chest auscultation and oxygen saturation measurement as a tool in the assessment of bronchial hyperreactivity. The cut-off level of 8 mg/mL for PCSat, owing to its highest discriminative capacity, may be useful for the diagnosis of asthma in preschool children.
