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Titolo:
SPIROMETRIC PATTERNS IN CHILDHOOD ASTHMA - PEAK FLOW COMPARED WITH OTHER INDEXES
Autore:
KLEIN RB; FRITZ GK; YEUNG A; MCQUAID EL; MANSELL A;
Indirizzi:
UNIV TEXAS,HLTH SCI CTR,DEPT PEDIAT,POB 2003 TYLER TX 75710 BROWN UNIV,RHODE ISL HOSP PROVIDENCE RI 02903
Titolo Testata:
Pediatric pulmonology
fascicolo: 6, volume: 20, anno: 1995,
pagine: 372 - 379
SICI:
8755-6863(1995)20:6<372:SPICA->2.0.ZU;2-B
Fonte:
ISI
Lingua:
ENG
Soggetto:
BRONCHIAL-ASTHMA; CHRONIC COUGH; CHILDREN; MANAGEMENT; RATES; MANIFESTATION; EDUCATION; EPISODES; SYMPTOMS;
Keywords:
PULMONARY FUNCTION TESTS; PEAK FLOW MONITORING; ASTHMA CAMPS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
34
Recensione:
Indirizzi per estratti:
Citazione:
R.B. Klein et al., "SPIROMETRIC PATTERNS IN CHILDHOOD ASTHMA - PEAK FLOW COMPARED WITH OTHER INDEXES", Pediatric pulmonology, 20(6), 1995, pp. 372-379

Abstract

The objective of this study was to determine patterns of pulmonary function abnormalities and to evaluate how adequately peak flow monitoring was correlated to other spirometric indices in childhood asthma. Ninety-one children, aged 8-15 years, with moderate-to-severe asthma were repeatedly tested in a summer camp. On-site medical staff permitted 24-hour-a-day supervision. Subjective and objective clinical evaluations of asthma status were made over 14 consecutive days. Detailed clinical history and clinical observations were made by an experienced staff, and a total of 2,663 pulmonary function tests were performed regularly three times daily and whenever a child sensed asthma symptoms. Patterns of obstruction were divided into large airway abnormalities and small airway abnormalities. There was a low concordance between standard large airway measures, such as the peak expiratory flow rate (PEFR)or the forced expiratory volume in 1 second (the FEV(1)), and measures of small airway obstruction, such as the forced expiratory flow rate25-75% (FEF(25-75)). Normal PEFR measurements do not always indicate that all other pulmonary function measures are normal. In fact, 18% ofchildren with a normal PEFR had abnormal FEF(25-75) values. Results demonstrated that the FEF(25-75) was the most specific and sensitive measure of airway obstruction. PEFR is widely used to monitor asthma symptoms objectively because it is technically simple to perform, relatively inexpensive, and helpful in most cases. It is, therefore, appropriate for asthma education programs to recommend PEFR as an objective measure to guide in making therapeutic decisions. Our data and clinical observations support the ''Guidelines for the Diagnosis and Managementof Asthma'' of the NIH Health Asthma Education Program that suggest that children have more complete pulmonary function testing along with frequent PEFR measures. Many children may appear asymptomatic, while recording normal PEFR measures, and still having significant asthma. Repeated pulmonary function testing and evaluation of the pattern of respiratory obstruction aids in managing this challenging group. We recommend that efforts be made to develop a simple and inexpensive method of measuring FEF(25-75) that will allow this measurement to be made even at home. (C) 1995 Wiley-Liss, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/09/20 alle ore 21:02:01