Journal Information
Vol. 57. Issue 1.
Pages 5-11 (1 July 2002)
Share
Share
Download PDF
More article options
Vol. 57. Issue 1.
Pages 5-11 (1 July 2002)
Full text access
Cuándo se considera positivo el test de broncodilatación
Cut-Off Point For A Positive Bronchodilation Test
Visits
12841
C. Pardos Martíneza,
Corresponding author
cpardosm@able.es

Correspondencia: Cantabria 10, 3º.A. 22004 Huesca. España.
, J. Fuertes Fernández-Espinara
a Centro de Salud Perpetuo Socorro, Huesca.
I. Nerín de la Puertab
b Unidad de Tabaquismo. Facultad de Medicina de Zaragoza.
E. González Pérez-Yarzac
c Unidad de Neumología Infantil. Hospital Donostia. San Sebastián. España.
This item has received
Article information
Objetivo

Determinar la broncodilatación que se produce en la población normal de 7 a 14 años de edad, para establecer el valor que define una prueba de broncodilatación como positiva.

Pacientes y métodos

Estudio transversal en niños sanos, no fumadores, realizado en ámbito escolar en la ciudad de Huesca en una muestra representativa (n = 145) de la población infantil de 7 a 14 años (N = 4.272). Se identificó salud mediante encuesta validada. Se monitorizó el monóxido de carbono (CO) espirado con un Micro III Smokerlyzer EC50®. La espirometría forzada basal y posbroncodilatación (salbutamol inhalado, 0,2 mg con cámara Babyhaler®) se realizaroncon un espirómetro Vitalograph mod. 2120®. Se midieron las variables capacidad vital forzada (FVC), volumen espiratorio máximo en el primer segundo (FEV1), FEV1/FVC, flujo espiratorio máximo entre el 25-75% de la FVC (FEF25-75) y pico espiratorio máximo (PEF). Para establecersi los incrementos de los parámetros seguían o no una distribución normal, se utilizó el contraste de Kolmogorov- Smirnov (modificación Lilliefors) y los histogramas. La relación entre el incremento de FEV1 y las variables del cuestionario se establecieron con el test de la t de Student (variables cualitativas) y la prueba de correlación de Pearson (variables cuantitativas). Para evaluar la fiabilidad del test se empleó el coeficiente de correlación no paramétrico de Spearman y los gráficos de dispersión.

Resultados

Incremento porcentual de FEV1 respecto al valor teórico: media (desviación estándar [DE]),Incremento porcentual de FEV1 respecto al valor previo: media.

Conclusiones

En niños de 7 a 14 años de edad, los incrementos porcentuales sobre el valor teórico o sobre el previo del FEV1 superiores al 9% definen la prueba de broncodilatación como positiva.

Palabras clave:
Espirometría forzada
Broncodilatación
Valores de referencia
Niños
Objective

To determine bronchodilation in healthy children aged 7-14 years in order to establish the value defining a positive bronchodilation test.

Patients and methods

We performed a cross-sectional study in healthy, nonsmoking schoolchildren aged 7-14 years in the city of Huesca (Spain). The sample (n = 145) was representative of the pediatric population aged 7-14 years (N = 4,272). Health was determined through a validated questionnaire. Expired carbon monoxide was measured with a Micro III Smokerlyzer EC50Ò. Forced basal and post-bronchodilation spirometry (0.2 mg of inhaled salbutamol with a Babyhaler chamber) was performed with a Vitalograph spirometer mod. 2120®. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow at 24-25% of forced vital capacity (FEF25-75%) and peak expiratory flow (PEF) were measured. To establish whether increments in the variables followed normal distribution, the Kolmogorov-Smirnov test (Lilliefors modification) and histograms were used. The relationship between increases in FEV1 and the variables in the questionnaire was analyzed using Student's t-test (qualitative variables) and Pearson's correlation (quantitative variables). To evaluate the reliability of the test, Spearman's non-parametric correlation coefficient and dispersion graphs were used.

Results

The percentage increase in FEV1 compared with the theoretical value was: mean (SD), 3.97 (2.65); 95 % percentile, 8.87%; and 97.5 percentile, 10.25%. The percentage increase in FEV1 compared with the previous value was: mean: 3.99 (2.63), 95-percentile: 8.43%; and 97.5 percentile: 10.14%.

Conclusions

In children aged 7-14 years, increases of greater than 9% above the theoretical or previous FEV1 value define the bronchodilation test as positive.

Key words:
Forced spirometry
Bronchodilation
Reference values
Children
Full text is only aviable in PDF
BibliografÍa
[1.]
J. Sanchís, P. Casan, J. Castillo, N. González, L. Palenciano, J. Roca.
Normativa para la práctica de la espirometría forzada.
ArchBronconeumol, 25 (1989), pp. 132-142
[2.]
American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease(COPD) and asthma.
Am Rev Respir Dis, 136 (1987), pp. 225-244
[3.]
R.E. Dales, W.O. Spitzer, P. Tousignant, M. Schechter, S. Suissa.
Clinicalinterpretation of airway response to a bronchodilator. Epidemiologicconsiderations.
Am Rev Respir Dis, 138 (1988), pp. 317-320
[4.]
P.H.H. Quanjer, G.J. Tammeling, J.E. Cotes, O.F. Pedersen, R. Peslin, J.C. Yernault.
Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests European Community for Steel and Coal.
Eur Respir J, 6 (1993), pp. 5s-40s
[5.]
P. Casan, J. Roca, J. Sanchis.
Spirometric response to a bronchodilator. Reference values for healthy children and adolescents.
Bull Europ Physiopath Resp, 19 (1983), pp. 567-569
[6.]
G. Dalen, B. Kjellman.
Assessment of lung function on healthy children using an electronic spirometer and an air-flowmeter before and after inhalation of an adrenergic receptor stimulant.
Acta Paediatr Scand, 68 (1979), pp. 103-108
[7.]
E.E. Ekwo, M.M. Weinberger, L.B. Dusdieker, W.H. Huntley, P. Rodgers, G.A. Maxwell.
Airways responses to inhaled isoproterenolin normal children.
Am Rev Respir Dis, 127 (1983), pp. 108-109
[8.]
G. Lis, J. Haluszka.
Standards in evaluating the test of obstruction reversibility based on the flow-volume curves.
PneumonolAlergol Pol, 59 (1991), pp. 20-24
[9.]
L.M. Taussig, V. Chernick, R. Wood, P.H. Farrell, R.B. Mellins.
Standardization of lung function testing in children. Proceedings and recommendations of the GAP conference committee, Cystic Fibrosis Foundation.
J Pediatr, 97 (1980), pp. 668-676
[10.]
American Thoracic Society. Standardization of spirometry-1987 Update.
Am Rev Respir Dis, 136 (1987), pp. 1285-1298
[11.]
M.D. Morato, E. González Pérez-Yarza, J.I. Emparanza, A. Pérez, A. Aguirre, A. Delgado.
Valores espirométricos en niños sanosde un área urbana de la Comunidad Autónoma Vasca.
An EspPediatr, 51 (1999), pp. 17-21
[12.]
M.J. Jarvis, H. Tunstall-Pedoe, C. Feyeranbend, C. Vesy, Y. Sallojee.
Comparison of test used to distinguish smokers.
Am J Pub Health, 77 (1978), pp. 1435-1438
[13.]
J.C. Dubus, M. Dolovich.
Emitted doses of salbutamol pressurized metered-dose inhaler from five different plastic spacer devices.
Fundam Clin Pharmacol, 14 (2000), pp. 219-224
[14.]
H.J. Waalkens, P.J.F.M. Merkus, E.E.M. Van Essen-Zandvliet, P.L.P. Brand, J. Gerritsen, E.J. Duiverman, et al.
and the Dutch CNSLD study group. Assessment of bronchodilator response in children with asthma.
Eur Respir J, 6 (1993), pp. 645-651
[15.]
R.W. Light, S.A. Conrad, R.B. George.
Clinical significance of pulmonary function tests. The one best test for evaluating the effects of bronchodilator therapy.
Chest, 72 (1977), pp. 512-516
[16.]
C. Shim.
Response to bronchodilators.
Clin Chest Med, 10 (1989), pp. 155-164
[17.]
A. Quezada, J. Mallol, J. Moreno, J. Rodriguez.
Effect of different inhaled bronchodilators on recovery from methacholine-induced bronchoconstriction in asthmatic children.
Pediatr Pulmonol, 28 (1999), pp. 125-129
[18.]
C. Pellicer, M. Perpiñá, A. De Diego, V. Macián.
Aportación del test broncodilatador al estudio de la reversibilidad bronquial.
Arch Bronconeumol, 30 (1994), pp. 492-497
[19.]
P.D. Bridge, H. Lee, M. Silverman.
A portable device based on the interrupter technique to measure bronchodilator response in schoolchildren.
Eur Respir J, 9 (1996), pp. 1368-1373
[20.]
O. Linna.
Spirometry, bronchodilator test or symptom scoring for the assessment of childhood asthma.
Acta Paediatr, 85 (1996), pp. 564-569
[21.]
H.A. Thiadens, G.H. De Bock, J.C. Van Houwelingen, F.W. Dekker, M.W.M. De Waal, M.P. Springer, et al.
Can peak expiratory flow measurement reliably identify the presence of airway obstruction and bronchodilator response as assessed by FEV1 in primare care patients presenting with a persistent coughα.
Thorax, 54 (1999), pp. 1055-1060
[22.]
G.L. Ruppel.
Spirometry.
Respir Care Clin North Am, 3 (1997), pp. 155-181
[23.]
P.L. Brand, P.H. Quanjer, D.S. Postma, H.A.M. Kerstjens, G.H. Koëter, P.N.R. Dekhuijzen, et al.
And the Dutch CNSLD study group. Interpretation of bronchodilator response in patients with obstructive airways disease.
Thorax, 47 (1992), pp. 429-436
Copyright © 2002. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?