Reduced lung function both before bronchiolitis and at 11 years

• Published in: Archives of disease in childhood Vol. 87; no. 5; pp. 417 - 420
• Main Authors: Turner, S W, Young, S, Landau, L I, Le Souëf, P N
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 01.11.2002; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD
• Subjects: Age; airway responsiveness to histamine; Asthma; Babies; Biological and medical sciences; Birthdays; Bronchiolitis; Bronchiolitis - physiopathology; Child; Children; Cohort Studies; Control Groups; Diagnosis; Diseases; dose response slope; DRS; Female; Forced Expiratory Volume - physiology; FRC; functional residual capacity; Functional Residual Capacity - physiology; Hospitals; Humans; Investigative techniques, diagnostic techniques (general aspects); longitudinal study; Lung - physiopathology; Male; Medical sciences; Original; Parents; Parents & parenting; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Peak Expiratory Flow Rate - physiology; Pediatric diseases; Physicians; Pregnancy; Prospective Studies; Questionnaires; Regression (Statistics); Respiratory diseases; Respiratory function; respiratory function testing; Respiratory Hypersensitivity - physiopathology; respiratory syncytial virus; Respiratory system; RSV; Smoking; Studies; upper respiratory tract infection; URTI; Vital Capacity - physiology; Young Children; United Kingdom; Human; Statistical analysis; Questionnaire; Respiratory disease; Etiopathogenesis; Age criterion; Morbidity; Bronchiolitis; Reduction; Lung function; Cohort study; Risk factor; Bronchus disease; Mechanism of action; Child
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/adc.87.5.417

Background and Aims: We have previously shown an association between reduced premorbid lung function (V‘maxFRC) and bronchiolitis. We hypothesised that individuals with bronchiolitis will go on to have reduced lung function and increased respiratory symptoms in childhood. Methods: V‘maxFRC was measured at 1 month of age; individuals with bronchiolitis were prospectively identified. Annual symptom questionnaires were completed from 3 to 6 years. At 11 years of age, children underwent an assessment including questionnaire, lung function, airway response to histamine (AR), and skin prick testing. Results: Eighteen individuals with bronchiolitis were ascertained from 253 cohort members. Children with bronchiolitis had increased viral induced wheeze at 3 (OR 5.8, 95% CI 1.4 to 25.2; n = 103) and 5 years (OR 5.3, 95% CI 1.1 to 25.5; n = 101). At 11 years of age, 194 children were assessed including 16 with past bronchiolitis. These 16 individuals had reduced mean z scores for % V‘maxFRC compared with other children (−0.56 and 0.06 respectively) and mean z scores for % FEF25–75 at 11 years (−0.53 and 0.06 respectively). At 11 years, FEV1, FVC PEF, AR, atopy, wheeze, and diagnosed asthma were not different between groups. Conclusions: Reduced lung function is present before and after bronchiolitis; the level of reduction is comparable. The mechanism for wheeze and reduced lung function after bronchiolitis appears to be related to premorbid lung function and not bronchiolitis per se.