Pulmonary function test in healthy children 7 to 9 years after respiratory viral infections

Pulmonary function tests in healthy children, 7 to 9 years after viral respiratory infections.

Cissy B. Kartasasmita,¹ Sri Sudarwati,¹ Diah A. Wulandari,¹  Adi U. Suardi,¹ Widya Saptaputra,² Nuradi Irwan,² Kuswandewi Mutyara,² Eric AF Simoes. ³

¹Department of Child Health, School of Medicine, Padjadjaran University, Bandung, Indonesia. ² Health Research Unit,  School of Medicine, Padjadjaran University, Bandung, Indonesia. ³ Department of Pediatrics, Section Infectious Diseases, University of Colorado School, Denver, and  The Children’s Hospital, Aurora, Colorado, USA.

Background. Pulmonary function test (PFTs) provides an assessment of airflow limitation. It can be used for diagnosis of asthma in children over 6 years of age. Viral infections  during infancy can cause wheezing  (Roberg et al. 2007) and abnormal lung function at 6 years of age (Anderson et al. 2008). The aim of this study is to determine the PFTs in children 7 to 9 years after viral respiratory infections.

Materials and Methods.  This study is a part of a nested case control study entitled  “RSV and recurrent wheezing in Indonesia: 7 – 9 year follow-up study with lung function studies”.  The PFTs  were obtained from December 2009 to July 2010. All the children were healthy when the PFTs were performed. To determine the obstructive impairment we analyzed FEV1 and FEV1/FVC ratio. Reversibility was measured in children with % predictive FEV1 < 80%, before and  after administration of a short acting bronchodilator.The FEV1/FVC ratio > 80% showed normal lung function.

Results. A total  218 children, age 8.4 to 13.4 years old (mean 10.5 ± 1.05 years), consisted of 111 boys and 107 girls, were enrolled in the study. Fifty two cases with history of viral respiratory infections, and 166 controls. The viral pathogens found were: RSV (25), RV (19), mix RSV and RV (6), and hMPV (2).  The mean ± SD of  FEV1 in cases (2.12 ± 0.42) was slightly higher than control (2.04 ± 0.39),  however, the difference was statisticaly not significant. The mean ± SD FEV1/FVC ratio  in cases (90.76 ± 9.15) and in control (92.28 ± 6.5) were also  statisticaly no difference. In 14 out of 218 (6.4%) children the reversibility test were > 12%.

Conclusion: The PFTs in children with history of viral respiratory infections are within normal limit, 7 to 9 years later. The rate of asthma is low.