0
Clinical Investigations: PULMONARY FUNCTION |

Acceptability, Reproducibility, and Sensitivity of Forced Expiratory Volumes and Peak Expiratory Flow During Bronchial Challenge Testing in Asthmatic Children*

L. Pekka Malmberg, MD, PhD; Kurt Nikander, BA; Anna S. Pelkonen, MD, PhD; Pirkko Syvänen, MD; Tuula Koljonen, RN; Tari Haahtela, MD, PhD; Markku Turpeinen, MD, PhD
Author and Funding Information

*From the Division of Allergology (Drs. Malmberg, Pelkonen, Syvänen, Haahtela, Turpeinen, and Mrs. Koljonen), Helsinki University Central Hospital, Helsinki, Finland; and AstraZeneca R & D (Mr. Nikander), Lund, Sweden.

Correspondence to: L. Pekka Malmberg, MD, PhD, Division of Allergology, Helsinki University Central Hospital, PO Box 160, FIN-00029 Helsinki, Finland; e-mail: pekka.malmberg@hus.fi



Chest. 2001;120(6):1843-1849. doi:10.1378/chest.120.6.1843
Text Size: A A A
Published online

Objectives: To compare the acceptability, reproducibility, and sensitivity of spirometric outcome measures of airway caliber during challenge testing in children.

Design: FEV1, forced expiratory volume in 0.75 s, forced expiratory volume in 0.5 s, and peak expiratory flow (PEF) were recorded during stepwise dosimetric histamine challenge tests. The responses were compared, and the reproducibility at baseline and from duplicate measurements at each challenge step was determined.

Patients: One hundred five children with newly diagnosed asthma, aged 5 to 10 years.

Results: Compared to PEF, FEV1 showed better baseline reproducibility (p = 0.002) and higher sensitivity (p < 0.0001) during challenge testing, determined as the change normalized to the baseline variation, while the forced expiratory volumes were not significantly different in these respects. During challenge testing in subjects with acceptable flow-volume tracings, paired recordings of FEV1 agreed within 0.1 L in 85% and within 0.2 L in 93% of measurements. During challenge testing, the reproducibility of FEV1 measurements was not better than that of the other indexes. Failure to exhale long enough precluded the use of FEV1 in 16 of the children, particularly the youngest children.

Conclusions: The results demonstrated that the recently published guidelines for FEV1 measurements during challenge tests can be applied to children. During challenge tests in asthmatic children, the advantage of the shorter fractions of forced expiratory volume was that they were more often acceptably recorded than FEV1, while they showed as good reproducibility and were also equally sensitive in assessing changes in airway obstruction.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
Diagnosis and management of asthma.
Institute for Clinical Systems Improvement
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543