Variability of Peak Expiratory Flow Rate as a Prognostic Index in Asymptomatic Asthma

Bellia, Vincenzo; Cibella, Fabio; Coppola, Paola; Greco, V.; Insalaco, Giuseppe; Milone, Francesco; Oddo, Silvia; Peralta, G.

doi:10.1159/000194707

Cited by 15 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such data are consistent with the results of Sont and coworkers,54 who showed improved asthma control if bronchial reactivity tests were used to guide asthma treatment. PEF monitoring reduces unscheduled doctors’ visits in adults,55 and PEF variation after bronchodilator response has been proven to be related to admission rates in adults and children 44,56,57. However, lung function deterioration and exacerbation risks are not always closely associated in children; Fuhlbrigge and colleagues51 reported that even children who had normal values of lung function had exacerbations.…”

Section: Classic Methods Of Assessment Of Asthma Control and Severitymentioning

confidence: 99%

Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control

Frey¹,

Suki²

2008

The Lancet

133

123

View full text Add to dashboard Cite

Although assessment of asthma control is important to guide treatment, it is difficult since the temporal pattern and risk of exacerbations are often unpredictable. In this Review, we summarise the classic methods to assess control with unidimensional and multidimensional approaches. Next, we show how ideas from the science of complexity can explain the seemingly unpredictable nature of bronchial asthma and emphysema, with implications for chronic obstructive pulmonary disease. We show that fluctuation analysis, a method used in statistical physics, can be used to gain insight into asthma as a dynamic disease of the respiratory system, viewed as a set of interacting subsystems (eg, inflammatory, immunological, and mechanical). The basis of the fluctuation analysis methods is the quantification of the long-term temporal history of lung function parameters. We summarise how this analysis can be used to assess the risk of future asthma episodes, with implications for asthma severity and control both in children and adults.

show abstract

Section: Classic Methods Of Assessment Of Asthma Control and Severitymentioning

confidence: 99%

Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control

Frey¹,

Suki²

2008

The Lancet

133

123

View full text Add to dashboard Cite

show abstract

“…Spirometric measures of lung function are not easily obtainable in certain clinical settings and/or geographic areas, and thus, although controversial [31], peak expiratory flow (PEF) has been proposed as a surrogate measure of FEV 1 [32]. Thamrin et al .…”

Section: Predicting Asthma Exacerbationsmentioning

confidence: 99%

Predicting asthma exacerbations in children

Forno

Celedón

2012

Current Opinion in Pulmonary Medicine

View full text Add to dashboard Cite

Purpose of the review To critically assess recently published literature on predicting asthma exacerbations in children, while also providing general recommendations for future research in this field. Recent findings Current evidence suggests that every effort should be made to provide optimal treatment to achieve adequate asthma control, as this will significantly reduce the risk of severe disease exacerbations. Children who have had at least one asthma exacerbation in the previous year are at highest risk for subsequent exacerbations, regardless of disease severity and/or control. Although several tools and biomarkers to predict asthma exacerbations have been recently developed, these approaches need further validation and/or have only had partial success in identifying children at risk. Summary Although considerable progress has been made, much remains to be done. Future studies should clearly differentiate severe asthma exacerbations due to inadequate asthma control from those occurring in children whose asthma is well controlled, utilize standardized definitions of asthma exacerbations, and use a systematic approach to identify the best predictors after accounting for the multiple dimensions of the problem. Our ability to correctly predict the development of severe asthma exacerbations in an individual child should improve in parallel with increased knowledge and/or understanding of the complex interactions among genetic, environmental (e.g., viral infections) and lifestyle (e.g., adherence to treatment) factors underlying these events.

show abstract

“…While it is well established that variation in airway function is a central feature of the disease, this is largely based on longterm variability of airway obstruction from several diurnal measurements of FEV1 and peak expiratory flow rate (PEFR) over several weeks or months of measurement [32,33]. Indeed, high diurnal variation of PEFR is associated with a higher risk for exacerbation [32].…”

Section: Variation In Rrsmentioning

confidence: 99%

“…Indeed, high diurnal variation of PEFR is associated with a higher risk for exacerbation [32]. Long-term variation has also been assessed by FOT showing that within-day and between-day variability in Rrs is elevated in asthma [34].…”

Section: Variation In Rrsmentioning

confidence: 99%

Airway resistance variability and response to bronchodilator in children with asthma

Lall¹,

Cheng²,

Hernández³

et al. 2007

Eur Respir J

View full text Add to dashboard Cite

Variability of airway function is a feature of asthma, spanning timescales from months to seconds. Short-term variation in airway resistance (Rrs) is elevated in asthma and is thought to be due to increased variation in the contractile activation of airway smooth muscle. If true, then variation in Rrs should decrease in response to bronchodilators, but this has not been investigated.Using the forced oscillation technique, Rrs and the variation in Rrs from 4-34 Hz were measured in 39 children with well-controlled mild-to-moderate asthma and 31 healthy controls (7-13 yrs) before and after an inhaled bronchodilator (200 mg salbutamol) or placebo.In agreement with other findings, baseline Rrs at all frequencies and the SD of Rrs (Rrs SD) below 14 Hz were found to be elevated in asthma while neither forced expiratory volume in one second nor the mean forced expiratory flow between 25 and 75% of forced vital capacity were different compared with controls. The present authors found that Rrs SD changed the most of any measurement in asthma, and this was the only measurement that changed significantly more in children with asthma following bronchodilator administration.The present results show that like airway narrowing, short-term airway variability of resistance may be a characteristic feature of asthma that may be useful for monitoring response to therapy.

show abstract

Variability of Peak Expiratory Flow Rate as a Prognostic Index in Asymptomatic Asthma

Cited by 15 publications

References 10 publications

Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control

Complexity of chronic asthma and chronic obstructive pulmonary disease: implications for risk assessment, and disease progression and control

Predicting asthma exacerbations in children

Airway resistance variability and response to bronchodilator in children with asthma

Contact Info

Product

Resources

About