TY - JOUR
T1 - Peak flow variation in childhood asthma
T2 - A three-year analysis
AU - Gern, James E.
AU - Eggleston, Peyton A.
AU - Schuberth, Kenneth C.
AU - Eney, N. Donald
AU - Goldstein, Eugene O.
AU - Weiss, Michael E.
AU - Adkinson, N. Franklin
N1 - Funding Information:
Supported by National Institutes Health grants AI21073 and AI07007 and the Eudowood Fund. Procedures were conducted the Pediatric Clinical Research Unit, and computational assistance was received from CLINFO, spon-sored by National Institutes of Health grant RR00035.
PY - 1994/4
Y1 - 1994/4
N2 - Measuring peak expiratory flow (PEF) variation has been suggested as a indicator of asthma disease severity and also of nonspecific bronchial hyperreactivity. To test these assumptions, we examined the relationships between PEF variation, methacholine reactivity, symptom scores, and medication requirements in 74 children with tightly controlled allergic asthma. The level of mean diurnal variation (MDV) for the group was 7.1%, which is generally regarded as normal. We found statistically significant correlations between MDV and both methacholine reactivity (r = 0.43, p = 0.0001) and symptom scores (r = 0.28, p = 0.016). These asthma variables were analyzed longitudinally in 33 children who were followed up at 6-month intervals for at least 36 months. Visit-to-visit changes in MDV were generally not reflective of changes in other variables. However, group levels of MDV gradually decreased over time, especially in children with initial MDV of more than 8%. This reduction in group MDV coincided with similar reductions in group medication requirements and methacholine reactivity. We conclude that children with moderately severe asthma that is tightly controlled may have normal levels of PEF variation. The correlation between PEF variation and other asthma variables is statistically significant but too weak to be useful in the treatment of individual patients. In contrast, measurement of MDV may be a useful indicator of disease severity in group studies of asthma.
AB - Measuring peak expiratory flow (PEF) variation has been suggested as a indicator of asthma disease severity and also of nonspecific bronchial hyperreactivity. To test these assumptions, we examined the relationships between PEF variation, methacholine reactivity, symptom scores, and medication requirements in 74 children with tightly controlled allergic asthma. The level of mean diurnal variation (MDV) for the group was 7.1%, which is generally regarded as normal. We found statistically significant correlations between MDV and both methacholine reactivity (r = 0.43, p = 0.0001) and symptom scores (r = 0.28, p = 0.016). These asthma variables were analyzed longitudinally in 33 children who were followed up at 6-month intervals for at least 36 months. Visit-to-visit changes in MDV were generally not reflective of changes in other variables. However, group levels of MDV gradually decreased over time, especially in children with initial MDV of more than 8%. This reduction in group MDV coincided with similar reductions in group medication requirements and methacholine reactivity. We conclude that children with moderately severe asthma that is tightly controlled may have normal levels of PEF variation. The correlation between PEF variation and other asthma variables is statistically significant but too weak to be useful in the treatment of individual patients. In contrast, measurement of MDV may be a useful indicator of disease severity in group studies of asthma.
KW - Peak expiratory flow
KW - asthma
KW - bronchial hyperreactivity
KW - children
KW - methacholine
KW - pulmonary function tests
KW - variability
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U2 - 10.1016/0091-6749(94)90250-X
DO - 10.1016/0091-6749(94)90250-X
M3 - Article
C2 - 8163780
AN - SCOPUS:0028345833
SN - 0091-6749
VL - 93
SP - 706
EP - 716
JO - The Journal of allergy and clinical immunology
JF - The Journal of allergy and clinical immunology
IS - 4
ER -