Klin Padiatr 2022; 234(05): 331
DOI: 10.1055/s-0042-1754478
Abstracts
Poster
Poster Walk 2: Lungenfunktion, Infektiologie und Tuberkulose

Alterations in ventilation inhomogeneity in school-aged children with wheeze – the LUftibus in the school study (LUIS)

A-C Kentgens
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
2   Graduate School for Health Sciences, University of Bern, Bern, Switzerland
,
JM Kurz
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
2   Graduate School for Health Sciences, University of Bern, Bern, Switzerland
,
R Mozún
3   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
4   University Children`s Hospital Zurich and Children’s Research Center, University of Zurich, Department of Respiratory Medicine, Zurich, Switzerland
,
ESL Pedersen
3   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
,
J Usemann
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
4   University Children`s Hospital Zurich and Children’s Research Center, University of Zurich, Department of Respiratory Medicine, Zurich, Switzerland
5   University Children`s Hospital Basel (UKBB), Basel, Switzerland
,
CE Kuehni
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
,
P Latzin
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
,
A Moeller
4   University Children`s Hospital Zurich and Children’s Research Center, University of Zurich, Department of Respiratory Medicine, Zurich, Switzerland
,
F Singer
1   Inselspital, Bern University Hospital, University of Bern, Division of Respiratory Medicine and Allergology, Department of Paediatrics, Bern, Switzerland
4   University Children`s Hospital Zurich and Children’s Research Center, University of Zurich, Department of Respiratory Medicine, Zurich, Switzerland
6   Medical University of Graz, Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Graz, Austria
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Introduction Wheeze is a common respiratory symptom in children. The association of wheeze and ventilation inhomogeneity, a biomarker of peripheral airway function, is poorly understood in children. We assessed the feasibility of double-tracer gas single-breath washout (DTG-SBW) measurement and the association of wheeze with ventilation inhomogeneity in unselected children of a large pediatric field study.

Methods A mobile lung function-testing unit (motorbus) visited schools in Canton Zurich (Switzerland). We applied questionnaires, tidal SBW using a helium sulfur-hexafluoride (S6-He) gas mixture, exhaled nitric oxide (FeNO) and spirometry measurements in unselected school-aged children. Outcomes were success rate of DTG-SBW and differences in DTG-SBW phase III slope (SIIISF6-He), FeNO, and FEV1 between children with wheeze (i.e. at least one wheeze episode in the preceding year) and those without.

Results 1547 out of 1962 (79%) children successfully performed DTG-SBW. From all children with successful DTG-SBW trials 295 children (19%) had wheeze. On the population level, we found small but systematic differences in ventilation inhomogeneity, airway inflammation and airflow between groups. In children with wheeze vs those without, mean (SD) SIIISF6-He was -0.24 (0.40) g/mol/L vs -0.33 (0.37) g/mol/L, p<0.001; median FeNO [IQR] 14.20 [7.20-28.80] vs 10.20 [5.65-17.70] ppb, p<0.001; FEV1 -0.68 (0.99) vs -0.50 (0.96) z-score, p<0.010. On the individual level, very few children had values beyond the limits of normal.

Conclusion The DTG-SBW is feasible in a pediatric field study setting. Wheeze in children was associated with subtle but systematic alterations in ventilation inhomogeneity, airflow and airway inflammation.



Publication History

Article published online:
21 September 2022

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