Assessment of Bronchial Hyperresponsiveness Using Chest Auscultation and Oxygen Saturation Measurement in Pre-school Children with a History of Wheezing

Yoo, Young; Yu, Jinho; Kang, Hee; Kang, Eun Kyeong; Koh, Young Yull

Abstract

PURPOSE
This study aimed to determine the efficacy and usefulness of chest auscultation and oxygen saturation measurement in the assessment of bronchial hyperresponsiveness to inhaled methacholine in pre-school wheezing children.
METHODS
One hundred and four children with histories of wheezing underwent bronchial challenges with nebulized methacholine using chest auscultation and oxygen saturation measurement. The challenge was considered positive when PCW(provocation concentration at wheezing), PCSat(provocation concentration at 5% fall of oxygen saturation), or PCRR(provocation concentration at 50% increase in respiratory rate), was detected below 8 mg/mL of methacholine concentration. Patients were grouped according to their history of wheezing in the previous year:Group 1(children who had no episode, n=45), Group 2(children who wheezed one or two times, n=18), and Group 3(children who wheezed more than three times, n=41). Thirty-three children with no history of wheezing served as normal controls.
RESULTS
The geometric means of PCW and PCSat of Group 2 and Group 3 were significantly lower than that of the control group(P<0.0001). There were decreasing tendencies of the geometric means of PCW and PCSat in the order of Group 1, Group 2, and Group 3. The PCRR of Group 3 was significantly lower than the other groups. The proportions of positive responses tend to increase in the order of control group, Group 1, Group 2, and Group 3(P<0.0001).
CONCLUSION
We propose that chest auscultation and oxygen saturation measurement for the assessment of bronchial hyperresponsiveness to methacholine in pre-school children are effective and useful for diagnosis of asthma.