Therapeutic and investigational evaluation of asthmatic children

Chai, Hyman; Purcell, Kenneth; Brady, Kirk; Falliers, Constantine J.

doi:10.1016/0021-8707(68)90005-1

Cited by 93 publications

(16 citation statements)

References 4 publications

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“…FERGUSON [10] concluded that airway obstruction may be present in a large proportion of asymptomatic children with asthma who have normal PEF, and suggested that frequent assessment of forced mid-expiratory (FEF25-75) is required. Over 27 yrs ago, CHAI et al [11] showed that infrequent measurements of lung function in asthmatics could give a highly erroneous impression of severity because of the variability of the disease.…”

mentioning

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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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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mentioning

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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“…Chai et al [3] and Connolly and Godfrey [4], in claiming that isolated measurements of lung function are virtually valueless in the assessment of the severity of asthma, based their arguments on the variability of airways obstruction as measured by PEFR.…”

Section: Discussionmentioning

confidence: 99%

Physiological Assessment of Severe Chronic Asthma in Children

Steiner¹,

Phelan²

1978

Respiration

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Measurements of maximum expiratory flows and lung volumes were made on 6 occasions at weekly intervals in 14 children who were known over several years to have severe chronic asthma. 11 of the 14 had persistent lung hyperinflation and marked reduction in maximum expiratory flow rates although there was considerable variability in individual measurements. The other 3 usually had hyperinflation and reduced expiratory flow rates. 3 times daily measurements at home of peak expiratory flow rate did not contribute further to assessment. The results of the study indicated that one or two measurements of maximum expiratory flow calculated from a maximum expiratory flow volume curve and of lung volumes recorded in a body plethysmograph are of value in identifying the child with severe chronic asthma.

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“…One of the difficulties in the objective assessment of the response to drugs of asthmatic subjects is that because of the extreme variability of the disease from day to day spirometric and other physiological measurements made only occasionally during the course of treatment may remain unchanged in spite of a real improvement in clinical condition (Falliers, McCawn, Ellis, and Chai, 1966;Chai, Purcell, Brady, and Falliers, 1968;Robertson et al, 1969). Another problem in the long-term assessment of children with asthma is the spontaneous improvement in clinical condition which can be expected even in the course of one year (Williams and McNicol, 1969 For these reasons a long-term double-blind trial of D.S.C.G.…”

Section: Introductionmentioning

confidence: 99%