Variation in peak expiratory flow of normal and asymptomatic asthmatic children

Albertini, M.; Politano, Stephen; Bérard, Emilie; Boutte, P; Mariani, Ronald

doi:10.1002/ppul.1950070305

Cited by 19 publications

(7 citation statements)

References 10 publications

(2 reference statements)

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“…Most studies have reported greater diurnal variation in PEF both in adults and children with asthma using the (HI-LO)VRB index [12,19,[28][29][30]. However, HENDERSON and CARSWELL [31] found mean values of 8.8% in normal children and 12.5% in asthmatics -a smaller difference than in adults and similar to the low PEF variation in the present study.…”

Section: Discussioncontrasting

confidence: 55%

“…All values for lung function were normalized by expressing them as percentage of predicted normal for each patient using the appropriate European Coal and Steel Community (ECCS) normal data. The diurnal variation in PEF on a day-today basis, the (HI-LO) VRB index, was calculated as described by ALBERTINI et al [12] and recommended in the international consensus report on the diagnosis and treatment of asthma [4], where:…”

Section: Analysis Of Datamentioning

confidence: 99%

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Home recording of PEF in young asthmatics: does it contribute to management?

Uwyyed¹,

Springer²,

Avital³

et al. 1996

Eur Respir J

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The value of home monitoring of peak expiratory flow (PEF) as part of an action plan for asthma management in children and young adults is uncertain. We sought to determine whether home recording of PEF benefited asthma management and whether any contribution was affected by the severity of the asthma.Twenty-eight children and young adults with asthma of different severity (mean age 14 yrs; 95% confidence interval (95% CI) 12-16 yrs) recorded their symptoms, drug consumption and PEF twice daily for a mean of 82 days over a 12 week period, and attended the laboratory every 2 weeks for measurement of lung function.The number of individual patients with significant correlations for laboratory lung function tests compared with ambulatory PEF and diary scores averaged over the preceeding 2 weeks was low in all severity groups. When measured in the laboratory, PEF meter readings correlated poorly with PEF measured by spirometry. The proportion of patients with significant correlations for PEF, symptoms and rescue bronchodilator use on a day-to-day basis was 70-80% in the group of severe asthmatics and significantly less in the mild asthmatics. In a subgroup of 14 patients who were sick on a mean of 19 days, the mean difference in PEF between well and sick days was 14% of predicted. Diurnal PEF variation correlated poorly with other parameters in all groups.It is concluded that PEF monitoring adds little to daily recording of symptoms and bronchodilator use in the management of young patients with severe asthma, and it is too insensitive to register meaningful clinical changes in those with milder asthma.

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Section: Discussioncontrasting

confidence: 55%

Section: Analysis Of Datamentioning

confidence: 99%

Home recording of PEF in young asthmatics: does it contribute to management?

Uwyyed¹,

Springer²,

Avital³

et al. 1996

Eur Respir J

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“…Albertini and coworkers found corresponding values of 15 2% in well controlled asthmatic children and 9 9% in non-asthmatic children. 23 Brand and co-workers24 and Henneberger and coworkers25 studied asthmatic subjects only and found mean values of 14 5% and 17% respectively for amplitude % mean of PEF values. We also examined the circadian variations using cosinor analysis which matches biological rhythms with sinusoidal functions.…”

Section: Discussionmentioning

confidence: 97%

Comparison of circadian variations using FEV1 and peak expiratory flow rates among normal and asthmatic subjects.

Troyanov

Ghezzo

Cartier

et al. 1994

Thorax

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Background -Most studies that describe circadian variations in asthma have used maximum rate of peak expiratory flow (PEF) rather than forced expiratory volume in one second (FEVy) Circadian variations in airway calibre can be assessed by various arithmetical indices -for example, differences between highest and lowest values, coefficient of variation7 -and cosinor analysis which matches biological rhythms with sinusoidal functions by depicting the acrophase (timing of the maximum value), mesor (maximum value), and the differences between the highest and lowest values (amplitude or peak to trough value). Although the maximum rate of peak expiratory flow (PEF) can be assessed with inexpensive portable instruments as a physiological index, it reflects primarily large airway calibre and is less sensitive and specific than forced expiratory volume in one second (FEVy). Until recently, however, it was not possible to record FEV1 serially, so most studies of circadian variations in asthma were conducted using PEF.7-'0 The studies in which FEV1 was assessed were carried out over short intervals of one day at a time (not serially) and results were not compared with PEF."-'5The aim of this study was to compare circadian rhythms obtained by PEF and FEV1 recording simultaneously in normal subjects and in asthmatic subjects in a stable clinical state.

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“…In conclusion, a variety of indoor and outdoor pollutants, including bioaerosols, have been shown to affect lung function in those with pre-existing disease [8, 10, 11, 16, 23, 83-86, 89, 111, 159, 160, 162-164, 166, 173-176] as well as symptoms; PEF appears to be a more sensitive instrument for detecting such changes [166,177,178].…”

Section: Pm/o 3 and Copdmentioning

confidence: 99%

Epidemiological studies of the respiratory effects of air pollution

Lebowitz¹

1996

Eur Respir J

112

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Environmental epidemiological studies of the health effects of air pollution have been major contributors to the understanding of such effects. The chronic effects of atmospheric pollutants have been studied, but, except for the known respiratory effects of particulate matter (PM), they have not been studied conclusively. There are ongoing studies of the chronic effects of certain pollutant classes, such as ozone, acid rain, airborne toxics, and the chemical form of PM (including diesel exhaust).Acute effects on humans due to outdoor and indoor exposures to several gases/fumes and PM have been demonstrated in epidemiological studies. However, the effects of these environmental factors on susceptible individuals are not known conclusively. These acute effects are especially important because they increase the human burden of minor illnesses, increase disability, and are thought to decrease productivity. They may be related to the increased likelihood of chronic disease as well. Further research is needed in this latter area, to determine the contributions of the time-related activities of individuals in different microenvironments (outdoors, in homes, in transit). Key elements of further studies are the assessment of total exposure to the different pollutants (occurring from indoor and outdoor sources) and the interactive effects of pollutants.Major research areas include determination of the contributions of indoor sources and of vehicle emissions to total exposure, how to measure such exposures, and how to measure human susceptibility and responses (including those at the cellular and molecular level). Biomarkers of exposures, doses and responses, including immunochemicals, biochemicals and deoxyribonucleic acid (DNA) adducts, are beginning to promote some basic knowledge of exposure-response, especially the mechanisms. These will be extremely useful additions to standard physiological, immunological, and clinical instruments, and the understanding of biological plausibility. The outcomes of all this work will be the management of risks and the prevention of respiratory diseases related to air pollution. Eur Respir J., 1996Respir J., , 9, 1029Respir J., -1054 This work was supported by USA-NHLBI SCOR Grant HL14136.Previously published reviews of this series 1. Sandström T. Respiratory effects of air pollutants: experimental studies in humans. Eur Respir J 1995; 8: 976-995. 2. Chitano P, Hosselet JJ, Mapp CE, Fabbri LM. Effects of oxidant air pollutants on the respiratory system: insights from experimental animal research. Eur Respir J 1995; 8: 1357-1371. Heyder J, Takenaka S. Long-term canine exposure studies with ambient air pollutants. Eur Respir J 1996; 9: 571-584. This review of epidemiological studies of the respiratory effects of exposures to air pollutants follows excellent reviews of experimental studies in animals and humans that have recently appeared in the Journal [1][2][3]. It has relied both on prior reviews of the topic and on the extensive literature of the major research reports...

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Variation in peak expiratory flow of normal and asymptomatic asthmatic children

Cited by 19 publications

References 10 publications

Home recording of PEF in young asthmatics: does it contribute to management?

Home recording of PEF in young asthmatics: does it contribute to management?

Comparison of circadian variations using FEV1 and peak expiratory flow rates among normal and asthmatic subjects.

Epidemiological studies of the respiratory effects of air pollution

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