No abstract

Using HS inhalations significantly shortens LOS and lowers AR in preschool children presenting with an acute wheezing episode to the emergency department.

Wheezing preschoolers presenting to the ED is a unique population with significantly higher rate of positive S-API and adenosine-BCT compared with controls and frequently (50%) express eosinophilic airway inflammation.

Objective Bronchial challenge test (BCT) measures current airways‐hyperreactivity, however, its predictive role in pre‐school children (<6 years) for the diagnosis of asthma at school age is still debatable. We aimed to find whether preschool children with a positive adenosine or methacholine BCT are more prone to asthma at school age. Methods We included children aged 6–13 years with respiratory symptoms that were previously referred to our pulmonary function laboratory for BCT (methacholine or adenosine, depending on the question asked) at age 10 months to 6 years (baseline). BCT was considered positive based on spirometry results or wheezing, desaturation, and tachypnea reactions. The primary outcome measure was asthma diagnosis at school age using the well‐validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. We used logistic regression analysis to explore whether positive BCT could predict school‐age asthma while including age and collected modified asthma predictive index in the model. Results One hundred and fifty‐one of 189 children (53% males), completed the ISAAC questionnaire (response rate = 80%). Mean ages at BCT and at follow‐up were 3.9 ± 1.28 and 9.4 ± 1.85 years, respectively. At baseline, 40 of 67 had a positive adenosine test and 73 of 84 had a positive methacholine BCT. Thirty‐nine children were diagnosed with asthma at school age. Logistic regression analysis showed that a positive adenosine test at pre‐school age was the best predictor, significantly increasing the odds of asthma at school age by 6.34 (95% CI: 1.23–32.81, p = .028), while methacholine did not show significance (p = .69). Conclusion Choosing the relevant BCT for the question asked, positive adenosine, but not methacholine test, at pre‐school, may predict asthma at school age.