FEATURES OF AUTONOMIC RESPONSE IN CHILDREN WITH BRONCHIAL ASTHMA IN THE PERIOD OF EXACERBATION

Background: Asthma is one of the urgent problems of modern pediatrics, but neuroregulation mechanisms underlying this disease have not been fully disclosed so far. The autonomic interactions assessment in patients with bronchial asthma is important to understand the pathogenesis and prognosis of the disease. Objective: The aim of the study was to investigate features of autonomic response in children with asthma in the period of exacerbation. Methods: The autonomic nervous system (ANS) of 82 children aged 6 to 18 years old with asthma in the period of exacerbation were investigated. The spectral analysis of the heart rate variability and the correlation rhythmography method (skaterography) were used to assess the ANS state. Investigations were carried out at rest and after clinoorthostatic test. Results: Non-respiratory (slow) waves reflecting the degree of activity of humoral and neural canals of heart rate central regulation were dominated at the spectrogram of 72 (87.80%) children experiencing asthma attack; more than half of patients (58.53%) had predominantly very low-frequency component (VLF%) in the range of fluctuation rate that indicated the influence of neurohumoral regulation. A significant increase in vagosympathetic balance coefficient (LF / HF) was recorded after clinoorthostatic test indicating the activation of the sympathetic nervous system. According to the correlation rhythmography data, a considerable scattering of scattergram points was detected in patients in the baseline state that indicated the predominant influence of parasympathetic nervous system. After the clinoorthostatic test, on the contrary, we observed the «tightness» of the scattergram cloud that could indicate sympathicotonia. Conclusion: The imbalance of the autonomic nervous system in the form of activation of the sympathetic and neurohumoral regulation department was found in children with asthma.