Nietolerancja wysiłku u dzieci chorych na astmę oskrzelową, a obiektywna ocena wydolności oddechowej po wysiłku

Zdzisława Kycler, Jerzy Alkiewicz, Anna Bręborowicz, Urszula Bugaj

Streszczenie
The aim of the study was to assess the lung function after exercise in children with asthma diagnosis who suffered from effort intolerance. We examined 92 children (aged 5-18 years old) with mild and moderate asthma. Exercise challenge was performed on traedmill set and consisted of 6-8 minutes long running at 85% of maximal predicted heart rate for age. The patients were eligibled if FEV1 on admission was at least 70% of predicted value. Before the exercise test spirometric parameters of most children were situated within 80-120% of normal value. Positive exercise test (based on decrease of any spirometric parameters below a describing air flow) was observed in 20 children (21.7%). Decrease of FEV1 of more than 15% of initial value was found in 19.6%, 10-15% in 8.7%, 5-10% in 21.7% of evaluated children; decrease of less than 5% was noticed in 39.1% of children. The PEF value fall of more than 15% concerned 34.8% patients, 10-15% – was revealed in 21.7%, 5-10% in 11.9%, 5% in 20.7%. The lowest mean values of measured spirometric parameters were observed at 5th minute after exercise test. Twelve children needed short acting beta₂ agonist to reverse exercise induced obstruction. We found significant discrepancy between the asthmatic patients feeling of exercise intolerance and true asthma exacerbation after effort. Exercise intolerance, reported by children suffering from asthma should be verified by exercise test.

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