Peak flow variation in childhood asthma: correlation with symptoms, airways obstruction, and hyperresponsiveness during long term treatment with inhaled corticosteroids

Brand, P. L. P.; Duiverman, E. J.; Waalkens, HJ; Essen-Zandvliet, E. E. M. Van; Kerrebijn, K. F.; Group, the Dutch CNSLD Study

doi:10.1136/thx.54.2.103

“…Alguns estudos têm questionado o real papel da medida do PFE na redução da morbidade dos pacientes asmáti-cos [8][9][10] . Como a asma acomete principalmente as pequenas vias aéreas, o PFE só irá se alterar em uma fase mais tardia, após um aumento importante na resistência das vias aére-as.…”

Section: Introductionunclassified

“…A maioria dos estudos analisou crianças com asma moderada a grave, controladas com corticóide inalatório. Demonstrou-se que existe uma correlação fraca (r de Pearson variando de -0,34 a 0,5) entre alterações no PFE e sintomas sugestivos de piora da função pulmonar 3,8,10,11 . Por outro lado, são escassos os estudos análogos desenvolvidos no Brasil e América Latina 11 .…”

Section: Introductionunclassified

Peak expiratory flow monitoring in asthmatic children

Fonseca¹,

Fonseca²,

Rodrigues³

et al. 2006

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Objective: To correlate forced expiratory volume in 1 second (VEF 1 ) and peak expiratory flow (PEF) with clinical parameters in children with moderate and severe asthma.Methods: This was a non-concurrent cohort study, carried out at a pediatric pneumology clinic, in Belo Horizonte, MG, Brazil, between March and October 2002. The study enrolled children aged 5 to 16 years, with persistent asthma, being treated with a minimum of 500 µg/ day beclomethasone, and with symptoms under control for at least 3 months. Seventy-five patients (96.1%) were selected by simple randomization and monitored for 3 months, via a clinical severity scale and pulmonary function tests (PEF and VEF 1 ). Results were analyzed using Pearson s coefficient.Results: Correlations between absolute and percentage PEF figures and clinical severity score, were negative and very close to zero, signifying a weak correlation with no statistical significance. The same relationship was observed between VEF 1 and clinical severity score. The correlation between VEF 1 and PEF had a positive value with statistical significance (p = 0.000). Conclusions:Since the best parameter for evaluating airway obstruction is VEF 1 , the finding that there is a positive correlation between this measure and absolute PEF reinforces the importance of its use and allows for the recommendation that PEF be measured as part of the management of asthmatic children, particularly in severe cases.J Pediatr (Rio J). 2006;82(6):465-9: Asthma, monitoring, peak expiratory flow. ResumoObjetivo: Correlacionar as medidas de volume expiratório forçado no primeiro segundo (VEF 1 ), pico do fluxo expiratório (PFE) e parâme-tros clínicos em crianças com asma moderada a grave.Métodos: Trata-se de um estudo de coorte não concorrente, realizado em ambulatório de pneumologia pediátrica, em Belo Horizonte, MG, de março a outubro de 2002. Participaram do estudo crianças entre 5 e 16 anos, com asma persistente, em uso de beclometasona na dosagem mínima de 500 µg/dia, com sintomas controlados há pelo menos 3 meses. Foram selecionados 75 pacientes (96,1%) de forma aleatória simples, os quais foram acompanhados durante 3 meses, sendo avaliados o escore clínico e as provas de função pulmonar (PFE e VEF 1 ). Os resultados foram analisados através da regressão linear de Pearson.Resultados: Entre os valores absolutos e percentuais do PFE e o escore clínico, a correlação foi negativa e muito próxima a zero, o que significa uma correlação fraca, sem significância estatística. O mesmo se observa entre VEF 1 e escore clínico. A correlação entre VEF 1 e PFE apresentou valor positivo e com significância estatística (p = 0,000). Conclusões:Como o melhor parâmetro para avaliar obstrução de vias aéreas é o VEF 1 , o encontro de correlação positiva entre este e os valores absolutos do PFE reforça a importância do seu uso e permite recomendar a mensuração do PFE no manejo das crianças asmáticas, sobretudo nos casos graves.J Pediatr (Rio J). 2006;82(6):465-9: Asma, monitoramento, pico do fluxo expiratório. ...

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“…103 In some asthma control tools, lung function is numerically averaged or added with symptoms, 64,104 but if the tool includes several symptom items, these can outweigh clinically important differences in lung function. 105 In addition, low FEV 1 is a strong independent predictor of risk of exacerbations, even after adjustment for symptom frequency.…”

Section: Role Of Lung Function In Assessing Asthma Controlmentioning

confidence: 99%

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Kumbhare

¹

,

Strange

²

2018

Southern Medical Journal

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“…between alterations to PEF and symptoms suggestive of deteriorating pulmonary function. 3,8,10,11 However, analogous studies are scarce in Brazil and Latin America. 11 The objective of the work reported here was to attempt to correlate VEF 1 and PEF measurements with clinical parameters in clinically stable children and adolescents with moderate and severe asthma on inhaled corticoids, in addition to verifying the contribution that serial PEF measurements have to offer for the outpatients follow-up of these patients.…”

Section: Introductionmentioning

confidence: 99%

“…7 Some studies have questioned the true role of PEF measurements in the reduction of morbidity among asthmatic patients. [8][9][10] Since asthma primarily affects the smaller airways, PEF will only be altered during later phases, after a significant increase in airway resistance.…”

Section: Introductionmentioning

confidence: 99%

Pico do fluxo expiratório no acompanhamento de crianças asmáticas

Fonseca¹,

Fonseca²,

Rodrigues³

et al. 2006

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To correlate forced expiratory volume in 1 second (VEF 1 ) and peak expiratory flow (PEF) with clinical parameters in children with moderate and severe asthma.Methods: This was a non-concurrent cohort study, carried out at a pediatric pneumology clinic, in Belo Horizonte, MG, Brazil, between March and October 2002. The study enrolled children aged 5 to 16 years, with persistent asthma, being treated with a minimum of 500 µg/day beclomethasone, and with symptoms under control for at least 3 months. Seventy-five patients (96.1%) were selected by simple randomization and monitored for 3 months, via a clinical severity scale and pulmonary function tests (PEF and VEF 1 ). Results were analyzed using Pearson s coefficient.Results: Correlations between absolute and percentage PEF figures and clinical severity score, were negative and very close to zero, signifying a weak correlation with no statistical significance. The same relationship was observed between VEF 1 and clinical severity score. The correlation between VEF 1 and PEF had a positive value with statistical significance (p = 0.000).Conclusions: Since the best parameter for evaluating airway obstruction is VEF 1 , the finding that there is a positive correlation between this measure and absolute PEF reinforces the importance of its use and allows for the recommendation that PEF be measured as part of the management of asthmatic children, particularly in severe cases.J Pediatr (Rio J). 2006;82(6):465-9: Asthma, monitoring, peak expiratory flow.

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Peak flow variation in childhood asthma: correlation with symptoms, airways obstruction, and hyperresponsiveness during long term treatment with inhaled corticosteroids

Cited by 82 publications

References 26 publications

Peak expiratory flow monitoring in asthmatic children

Peak expiratory flow monitoring in asthmatic children

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

Pico do fluxo expiratório no acompanhamento de crianças asmáticas

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