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

on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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 FEV 1 and/or an FEV 1 /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 FEV 1 % predicted (p = 0.008). Subjects without allergic rhinitis had lower post-BD FEV 1 % 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.

Original languageEnglish (US)
Pages (from-to)611-617
Number of pages7
JournalJournal of Asthma
Volume56
Issue number6
DOIs
StatePublished - Jun 3 2019

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Multicenter Studies
Bronchodilator Agents
Asthma
Lung
Tobacco Smoke Pollution
Bronchiectasis
Respiratory Function Tests
Sinusitis
Premature Birth
Allergic Rhinitis
African Americans
Pneumonia
Obesity
Demography
Morbidity
Research

Keywords

  • Allergic rhinitis
  • bronchodilator
  • pulmonary function tests

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network (2019). Clinical characterization of children with resistant airflow obstruction, a multicenter study. Journal of Asthma, 56(6), 611-617. https://doi.org/10.1080/02770903.2018.1477956

Clinical characterization of children with resistant airflow obstruction, a multicenter study. / on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network.

In: Journal of Asthma, Vol. 56, No. 6, 03.06.2019, p. 611-617.

Research output: Contribution to journalArticle

on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network 2019, 'Clinical characterization of children with resistant airflow obstruction, a multicenter study', Journal of Asthma, vol. 56, no. 6, pp. 611-617. https://doi.org/10.1080/02770903.2018.1477956
on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network. Clinical characterization of children with resistant airflow obstruction, a multicenter study. Journal of Asthma. 2019 Jun 3;56(6):611-617. https://doi.org/10.1080/02770903.2018.1477956
on behalf of the American Lung Association Airway Clinical Research Centers (ALA-ACRC) Network. / Clinical characterization of children with resistant airflow obstruction, a multicenter study. In: Journal of Asthma. 2019 ; Vol. 56, No. 6. pp. 611-617.
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AU - Bacharier, Leonard

AU - Lang, Jason E.

AU - Irvin, Charles G.

AU - Kaminsky, David

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AU - Ryu, Julie

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KW - pulmonary function tests

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