engleski

Expiratory variability index (EVI) is associated with the severity of acute bronchial obstruction in small children: a proof of concept study.

Abstract BACKGROUND: Lung function testing in small children is cumbersome. However, reduced variability of tidal breathing recorded using impedance pneumography (IP) during sleep was recently found to be a potential objective marker of wheeze in children aged 1-5 years. We aimed to investigate how an acute bronchial obstruction (BO) and its severity, and recovery thereof reflects in expiratory variability index (EVI). METHODS: EVI was measured using a wearable IP system (Ventica®) during sleep in 40 healthy controls (aged 1.5-5.9 y) and 30 patients hospitalised due to acute BO (aged 1.3-5.3 y). In healthy controls EVI was measured for 1-3 nights at their homes. Patients were measured for several nights during hospitalisation, as practically feasible, and at home 2 and 4 weeks post- discharge. RESULTS: We received 79 EVI results from 39 controls and 139 from 30 patients. 90 % had previous BO episodes, 30 % used asthma controller medication before and 100 % after hospitalisation. Compared to controls, EVI was significantly lower during hospitalisation (p<0.0001) having significant correlation with number of days to discharge (r=-0.38, p=0.004). At 2 or 4 weeks post-discharge, EVI was not significantly different from the controls (p=0.14, p=0.49, respectively). EVI was significantly associated with chest auscultation findings (p=0.0001) being 17.5 (4.9) (median, IQR) with normal auscultation, 15.6 (7.4) in those with prolonged expiration, and 11.4 (6.8) in those with wheeze and/or rales and crackles. CONCLUSIONS: EVI was found to be a sensitive, objective marker of acute BO, showing strong association with changes in clinical status in wheezy children aged 1-5 years.

EVI, children, bronchial obstruction

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