Pediatr Allergy Respir Dis.  2004 Jun;14(2):133-141.

Diagnostic Value of Bronchial Hyperreactivity Using Chest Auscultation and Oxygen Saturation Measurement in Preschool Children with a History of Wheezing

• Suh DI
• Yoo Y
• Kim DK
• Yu J
• Kang H
• Koh YY

Abstract

PURPOSE
This study aimed to evaluate the validity of chest auscultation and oxygen saturation measurement in the assessment of bronchial hyperreactivity to inhaled methacholine in preschool children who were thought to be asthmatic clinically. METHODS: Seventy-two children with a history of more than three wheezing episodes in the previous year were considered the asthma group and underwent methacholine bronchial challenges. Provocation concentration at wheezing (PCw), at 5% fall of oxygen saturation (PCSat), and at 50% increase in respiratory rate (PCRR) were determined in each subject. One hundred and eighteen children who have had less than two wheezing episodes in their life served as control group. RESULTS: The geometric means of PCw, PCSat, and PCRR of asthma group were significantly lower than those of the control group. The optimal cut-off level for PCw was 8 mg/mL, giving a sensitivity of 63% and a specificity of 78%. Corresponding values for PCSat and PCRR were 8 mg/mL (72%, 67%) and 16 mg/mL (49%, 86%), respectively. The area under the receiver operating characteristic (ROC) curve for PCw, PCSat, and PCRR were 0.80, 0.88, and 0.70 respectively. The discriminative capacity of PCSat as judged by ROC curve analysis exceed those of PCw and PCRR. CONCLUSION: These findings provide support for the use of chest auscultation and oxygen saturation measurement as a tool in the assessment of bronchial hyperreactivity. The cut-off level of 8 mg/mL for PCSat, owing to its highest discriminative capacity, may be useful for the diagnosis of asthma in preschool children.

Keyword

Bronchial hyperreactivity; Methacholine inhalation; Chest auscultation; Oxygen saturation measurement; Respiratory rate; Bronchial provocation tests; Diagnostic value; Receiver operating characteristic curve; Preschool children

MeSH Terms

Asthma
Auscultation*
Bronchial Hyperreactivity*
Bronchial Provocation Tests
Child
Child, Preschool*
Diagnosis
Humans
Methacholine Chloride
Oxygen*
Respiratory Rate
Respiratory Sounds*
ROC Curve
Sensitivity and Specificity
Thorax*
Methacholine Chloride
Oxygen