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Clinical characterization of children with resistant airflow obstruction, a multicenter study.

Publication ,  Journal Article
Krishnan, S; Dozor, AJ; Bacharier, L; Lang, JE; Irvin, CG; Kaminsky, D; Farber, HJ; Gerald, L; Brown, M; Holbrook, JT; Wise, RA; Ryu, J ...
Published in: J Asthma
June 2019

OBJECTIVE: To characterize a cohort of children with airflow limitation resistant to bronchodilator (BD) therapy. METHODS: Pulmonary function tests performed in children 6-17 years of age at 15 centers in a clinical research consortium were screened for resistant airflow limitation, defined as a post-BD FEV1 and/or an FEV1/FVC less than the lower limits of normal. Demographic and clinical data were analyzed for associations with pulmonary function. RESULTS: 582 children were identified. Median age was 13 years (IQR: 11, 16), 60% were males; 62% were Caucasian, 28% were African-American; 19% were obese; 32% were born prematurely and 21% exposed to second hand smoke. Pulmonary diagnoses included asthma (93%), prior significant pneumonia (28%), and bronchiectasis (5%). 65% reported allergic rhinitis, and 11% chronic sinusitis. Subjects without a history of asthma had significantly lower post-BD FEV1% predicted (p = 0.008). Subjects without allergic rhinitis had lower post-BD FEV1% predicted (p = 0.003). Children with allergic rhinitis, male sex, obesity and Black race had better pulmonary function post-BD. There was lower pulmonary function in children after age 11 years without a history of allergic rhinitis, as compared to those with a history of allergic rhinitis. CONCLUSIONS: The most prevalent diagnosis in children with BD-resistant airflow limitation is asthma. Allergic rhinitis and premature birth are common co-morbidities. Children without a history of asthma, as well as those with asthma but no allergic rhinitis, had lower pulmonary function. Children with BD-resistant airflow limitation may represent a sub-group of children with persistent obstruction and high risk for life-long airway disease.

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Published In

J Asthma

DOI

EISSN

1532-4303

Publication Date

June 2019

Volume

56

Issue

6

Start / End Page

611 / 617

Location

England

Related Subject Headings

  • Vital Capacity
  • Retrospective Studies
  • Male
  • Lung Diseases
  • Humans
  • Forced Expiratory Volume
  • Female
  • Cross-Sectional Studies
  • Child
  • Allergy
 

Citation

APA
Chicago
ICMJE
MLA
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Krishnan, S., Dozor, A. J., Bacharier, L., Lang, J. E., Irvin, C. G., Kaminsky, D., … American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network, . (2019). Clinical characterization of children with resistant airflow obstruction, a multicenter study. J Asthma, 56(6), 611–617. https://doi.org/10.1080/02770903.2018.1477956
Krishnan, Sankaran, Allen J. Dozor, Leonard Bacharier, Jason E. Lang, Charles G. Irvin, David Kaminsky, Harold J. Farber, et al. “Clinical characterization of children with resistant airflow obstruction, a multicenter study.J Asthma 56, no. 6 (June 2019): 611–17. https://doi.org/10.1080/02770903.2018.1477956.
Krishnan S, Dozor AJ, Bacharier L, Lang JE, Irvin CG, Kaminsky D, et al. Clinical characterization of children with resistant airflow obstruction, a multicenter study. J Asthma. 2019 Jun;56(6):611–7.
Krishnan, Sankaran, et al. “Clinical characterization of children with resistant airflow obstruction, a multicenter study.J Asthma, vol. 56, no. 6, June 2019, pp. 611–17. Pubmed, doi:10.1080/02770903.2018.1477956.
Krishnan S, Dozor AJ, Bacharier L, Lang JE, Irvin CG, Kaminsky D, Farber HJ, Gerald L, Brown M, Holbrook JT, Wise RA, Ryu J, Bose S, Yasin R, Saams J, Henderson RJ, Teague WG, American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network. Clinical characterization of children with resistant airflow obstruction, a multicenter study. J Asthma. 2019 Jun;56(6):611–617.

Published In

J Asthma

DOI

EISSN

1532-4303

Publication Date

June 2019

Volume

56

Issue

6

Start / End Page

611 / 617

Location

England

Related Subject Headings

  • Vital Capacity
  • Retrospective Studies
  • Male
  • Lung Diseases
  • Humans
  • Forced Expiratory Volume
  • Female
  • Cross-Sectional Studies
  • Child
  • Allergy