Reference ranges for shape indices of the flow‐volume loop of healthy children

Nève, Véronique; Edmé, Jean-Louis; Baquet, Georges; Matran, Régis

doi:10.1002/ppul.23112

Cited by 9 publications

(12 citation statements)

References 21 publications

(38 reference statements)

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“…The b-angle is calculated as b = 180 2 tan Figure 3A); reference ranges were used to calculate z scores (zb-angle) for patients less than 25 years of age (6) To calculate the second derivative ( f99) of flow (V9) with respect to volume (V), raw flow and volume data (at 200 Hz) were exported from the ComPAS database, using software provided by the manufacturer. The extracted data were restricted to two boundary ranges: (b1) from the volume corresponding to peak flow to 75% of the vital capacity, and (b2) from 30 to 70% of FVC.…”

Section: Curvature Indicesmentioning

confidence: 99%

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

et al. 2016

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Rationale: Analysis of maximal expiratory flow-volume curves (MEFVCs) allows for determination of airway obstruction, but quantitative methods to describe these curves are not commonly used.Objectives: We sought to determine the variability in MEFVC concavity assessment by pulmonary physicians, whether objective indices of concavity can be substituted for subjective expert impression, and whether MEFVC concavity correlates with clinical outcomes.Methods: A survey of 37 MEFVCs (plus 3 duplicates) was sent to pulmonologists for quantitative assessment of MEFVC concavity. Objective indices (b-angle, ratio forced expiratory flow at 50% of total lung volume to peak expiratory flow rate [FEF 50 /PEFR], ratio of maximum mid-expiratory flow to FVC [MMEF/FVC], k max , and averaged flow-volume second derivatives) were calculated for each MEFVC and were correlated with the mean expert score. Both the mean expert scores and the best-performing index were then correlated with hospitalizations.Measurements and Main Results: Ninety-two respondents provided usable data. There was substantial variability in concavity scores between subjects, but strong intrasubject reliability. Mean expert score did not differ by physician years of experience. Several indices (b-angle, FEF 50 /PEFR, FEV 1 /FVC, MMEF/FVC, FEF 50 , and forced expiratory flow between 25 and 75% of total lung volume) correlated strongly with mean expert scores. A new variable (b-MMEF) was constructed using coefficients from stepwise linear regression and accurately predicted the mean expert score (R 2 = 0.96). Mean expert score and b-MMEF showed similar odds ratios for hospitalization (2.13 and 2.32, respectively) with identical positive (z71%) and negative (87%) predictive values. The b-MMEF was also associated with hospitalizations in two independent cohorts of children with asthma and cystic fibrosis. Conclusions:The b-MMEF is an objective measure of maximal expiratory flow-volume curve concavity and highly correlates with expert impression. Both the mean expert score for expiratory curve concavity and the b-MMEF were associated with increased risk of subsequent hospitalization. The b-MMEF may be a useful biomarker for disease severity in asthma and cystic fibrosis.

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Section: Curvature Indicesmentioning

confidence: 99%

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

et al. 2016

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“…Reference values were determined as described by NÈVE et al [10] and in the online supplementary material. Briefly, data were obtained from 446 Caucasian children (aged 2.5-15 years) [10]. The lambda-mu-sigma method was applied.…”

Section: Discussionmentioning

confidence: 99%

“…Data were analysed using the GAMLSS (generalised additive model for location scale and shape) package 4.1-1 in the statistical programme R (R Software 2.14.1; R Development Core Team, 2008, www.r-project.org). Reference equations for FEVt/FVC ratios are provided in online supplementary table E1 (reference equations for FEV1 and FVC are provided in [10]) and the coefficient of variation for FEVt/FVC in online supplementary figure E1.…”

Section: Discussionmentioning

confidence: 99%

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Utility of measuring FEV_0.75/FVC ratio in preschoolers with uncontrolled wheezing disorder

et al. 2016

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Uncontrolled wheezing disorder is common in preschoolers and disease control assessment is challenging as parents frequently overestimate the extent to which their child's disease is controlled. This is the first study of forced expiratory volume in t s (FEVt)/forced vital capacity (FVC) ratio measurements (i.e. FEV1/FVC, FEV0.75/FVC and FEV0.5/FVC) in wheezy preschoolers in relation to disease control. Our objective was to evaluate whether FEVt/FVC ratios less than the lower limit of normal (LLN; z-score <-1.64) were associated with uncontrolled wheezing disorder in preschoolers.Valid FVC, FEV1, FEV0.75 and FEV0.5 values were obtained in 92 healthy and 125 wheezy (62% uncontrolled) children (3-5 years). Associations between spirometry value

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“…FEV1 in VLBW adults were more predictive of adult FEV1 than was the case with normal BW adults. Jiang et al and Nève et al contributed to addressing the need for more normative data by assessing pulmonary function in normal school‐age subjects in their respective populations. The long‐term clinical implications of the apparent deficits in lung function among adult survivors of premature birth, particularly those diagnosed with BPD, is not yet clear, but may be more severe than earlier appreciated, as reviewed by Ronkainen et al…”

Section: Neonatal Lung Disease and Bronchopulmonary Dysplasia (Bpd)mentioning

confidence: 99%

Pediatric Pulmonologyyear in review 2015: Part 1

et al. 2016

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Our journal covers a broad range of research and scholarly topics related to children's respiratory disorders. For updated perspectives on the rapidly expanding knowledge in our field, we will summarize the past year's publications in our major topic areas, as well as selected publications in these areas from the core clinical journal literature outside our own pages. The current review covers articles on neonatal lung disease, pulmonary physiology, and respiratory infection.Word count: 71 3

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Reference ranges for shape indices of the flow‐volume loop of healthy children

Abstract: This study provides standard reference equations for indices of mid-expiratory flows in children and we suggest using the FEF50 /PEF index.

Cited by 9 publications

References 21 publications

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

Utility of measuring FEV_0.75/FVC ratio in preschoolers with uncontrolled wheezing disorder

Pediatric Pulmonologyyear in review 2015: Part 1

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Reference ranges for shape indices of the flow‐volume loop of healthy children

Abstract: This study provides standard reference equations for indices of mid-expiratory flows in children and we suggest using the FEF50 /PEF index.

Cited by 9 publications

References 21 publications

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

Subjective and Objective Assessments of Flow–Volume Curve Configuration in Children and Young Adults

Utility of measuring FEV0.75/FVC ratio in preschoolers with uncontrolled wheezing disorder

Pediatric Pulmonologyyear in review 2015: Part 1

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Product

Resources

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Utility of measuring FEV_0.75/FVC ratio in preschoolers with uncontrolled wheezing disorder