Peak Expiratory Flow Rate In Children Research Articles

Seasonal and monthly variation in peak expiratory flow rate in children with asthma.

BackgroundAlthough understanding the seasonal patterns of asthma deterioration is important to prevent asthma exacerbation, previous approaches have limitations in evaluating the actual trend of asthma exacerbation.ObjectiveThis study aimed to evaluate the seasonal and monthly variations in the peak expiratory flow rate (PEFR) among children with asthma.MethodsA total of 89 patients with asthma were enrolled between December 2012 and March 2015. The PEFR in the morning and evening was recorded daily, and the percentage change in PEFR from baseline was calculated. Generalized estimating equation models were constructed after adjusting for age, sex, body mass index, and sensitization to house dust mites or pollen.ResultsThe PEFR records of 11,222 person-days showed a significant decrease in the morning and evening in autumn than in winter by −1.9% (95% confidence interval [CI], −3.73 to −0.15) and −2.1% (95% CI, −3.80 to −0.37), respectively. The morning PEFR was significantly lower in April, August, October, and December than in January with changes of −4.2% (95% CI, −7.08 to −1.23) in April, −3.1% (95% CI, −5.79 to −0.47) in August, −3.7% (95% CI, −6.09 to −1.21) in October, and −1.9% (95% CI, −3.62 to −0.12) in December. The percentage change of evening PEFR significantly decreased by −3.3% (95% CI, −6.38 to −0.25) in April and by −3.3% (95% CI, −5.56 to −1.07) in October.ConclusionThe PEFR in children with asthma was lower in autumn than in winter. In terms of monthly patterns, the PEFR was significantly reduced in April and October than in January. These results can serve as a basis for preventing asthma exacerbations by developing seasonal or monthly management strategies for children with asthma.

A Cross Sectional Study to Assess Peak Expiratory Flow Rate in Healthy School Children for Establishment of Normative Data

Introduction: Peak Expiratory Flow Rate (PEFR) can be measured by cheap and portable instrument, peak flowmeter which is useful in detecting early asthmatic changes and monitoring the treatment response.
 Methods: This study was conducted on 1000 normal healthy children of nine to 14 years of age of either sex from various schools of Faridkot district in South West Punjab, India. Anthropometry was done and PEFR was measured using Mini Bell Peak Flow Meter. Linear regression analysis was done and normograms were constructed.
 Results: Linear regression equations were derived for PEFR with height, weight, BSA and BMI in boys and girls. The most significant correlation was seen with height (r = 0.527 in boys, r = 0.410 in girls) followed by body surface area (r = 0.506 in boys, r = 0.296 in girls). Body mass index had negative correlation (r = -0.200) with PEFR in girls. Nomograms were constructed on basis of linear regression equations of PEFR with height (-46.67 + 2.02 x height for boys, -12.64 + 1.50 x height for girls) and BSA (82.02 + 137.2 x BSA for boys, 96.61 + 88.11 x BSA for girls)
 Conclusion: There is need for nomogram for each region so that personal value of PEFR can be compared to normal reference population and also with predicted value from regression equation as PEFR varies from region to region. The nomograms and regression equations derived from this study can be useful for predicting normal values of PEFR of children of South West Punjab.

Correlates of peak expiratory flow rate and deriving the prediction equation in school going children of Lucknow

Background: Peak expiratory flow rate (PEFR) is an essential measure in the monitoring and evaluation of airway obstruction in asthmatic children. Studies on PEFR in children are limited. The objectives of the study were to evaluate PEFR in healthy school going children and its correlation with age, weight, height and Body Surface Area and to derive their prediction equations.Methods: We conducted a cross-sectional study in 1200 healthy school children age group of 5-15 years after approval from the institutional Ethical committee. All the analysis was carried out by using SPSS version 16.0. Pearson correlation coefficient was calculated to find the correlation between PEFR and anthropometric parameters among boys and girls. Results: PEFR was higher in boys than girls among all age groups except for 5 years of age. PEFR prediction equations were obtained both for boys and girls using multiple regression equations. For boys: 4.21* age in years2+0.68* height in cms – 2.48* weight in kg +322.85* BSA3 – 137.88 and for girls: 10.64* age in years1 +0.25* height in cms +0.09* weight in kg + 99.44* BSA -22.41 (1p=0.0001, 2p=0.001, 3p=0.007). Conclusions: We developed PEFR prediction equations in children using weight, height, and body surface area. This would be helpful in evaluation of children with airway diseases.

Effects of Ambient Fine Particles on Pulmonary Function in Children With Mild Atopic Dermatitis

ABSTRACT The effects of particulate pollutants on lung function in children with atopic dermatitis (AD) remain to be determined. The authors investigated the short-term effects of ambient particles on peak expiratory flow rate (PEFR) in 84 children with and without AD. Daily particulates less than 10, 2.5, and 1 μm (PM10, PM2.5, and PM1) and number concentrations of submicron particles were measured. The authors observed elevated levels of PM10, PM2.5, and PM1, and accumulation-mode particles were associated with decreased PEFR in children with AD. The PEFR decrements were −2.89 L/min (95% confidence interval [CI], −4.93 to −0.89) for an interquartile-range increase of previous-day PM10, −2.79 L/min (95% CI, −4.89 to −0.69) for PM2.5, and −2.71 L/min (95% CI, −4.81 to −0.61) for PM1. These results suggest that ambient fine particles may affect the pulmonary function in children with AD. The respiratory health of children with atopic skin disorders renders them more vulnerable to ambient particles than healthy subjects.

Childhood asthma and atmospheric conditions.

Bronchial asthma is the most common chronic respiratory illness in childhood. It is characterized by paroxysmal bronchospastic periods. There are many studies giving reasons to explain the bronchospasm periods. One of the reasons, atmospheric conditions, is effective in creating a clinical picture of asthmatic patients. In the present study, the correlation between atmospheric conditions and asthmatic symptoms in children was investigated using peak expiratory flow rate (PEFR) as the respiratory function test. Twenty-one children with bronchial asthma were monitored in the study. They were followed as outpatients of the Ege University Medical Faculty, Department of Pediatric Allergy and Pneumotology, between November 1993 and June 1994. Atmospheric conditions were recorded from the local meteorology center. Complaints and the PEFR of children were compared with the meteorological data. Asthmatic symptoms were increased by low temperatures in all asthmatic children. An increase was detected in the extrinsic group by relative humidity and ratio of cloud, but in the intrinsic group only by relative humidity.

Fungus spores, air pollutants, and other determinants of peak expiratory flow rate in children.

The impact of summertime haze episodes on daily variations in symptoms and peak expiratory flow rates (PEFRs) was examined in a study of 108 children living in State College, Pennsylvania, during the summer of 1991. Twice daily, each child recorded symptoms, PEFRs and hours spent outdoors. Environmental measurements included daily 12- and 24-hour averages for meteorologic and air pollutant variables and 24-hour average fungus spore concentrations. A 10,000-spore/m3 increment in Cladosporium spore concentration was associated with a deficit in morning PEFR (-1.0 liters/minute, 95% confidence interval (CI) -1.9 to -0.2). A 60-spore/m3 increment in Epicoccum spore concentration was associated with increased incidence of morning cough (odds ratio (OR) = 1.8, 95% CI 1.0-3.2) and a deficit in morning PEFR (-1.5 liters/minute, 95% CI -2.8 to -0.2). Fungi spore counts were not associated with respirable particle mass. A 125-nmol/m3 increment in 12-hour daytime particle-strong acidity was associated with a deficit in evening PEFR (-0.5 liters/minute, 95% CI -1.2 to 0.2) and increased incidence of cold episodes that evening or the subsequent morning (OR = 1.35, 95% CI 1.14-1.61). A 20-microgram/m3 increment in 24-hour respirable particles lagged by 24 hours was associated with a deficit in evening PEFR (-0.5 liters/minute 95% CI -1.4 to 0.4) and increased incidence of cough episodes that evening or the subsequent morning (OR = 1.37, 95% CI 1.13-1.66). These results confirm the acute effects of summertime particulate air pollution and suggest that aeroallergens have independent effects on respiratory symptoms and PEFR in children.

Peak expiratory flow rate and the acute chest syndrome in homozygous sickle cell disease.

The peak expiratory flow rate (PEFR) was studied in 20 matched pairs of children with homozygous sickle cell disease with either no episodes or six or more episodes of acute chest syndrome. The pairs were carefully matched for height and a highly significant reduction in PEFR was observed in children with multiple episodes of acute chest syndrome. Lateral and anteroposterior chest diameters and chest circumference correlated with PEFR but did not differ between index and control cases. The most likely cause of the reduced PEFR in children with multiple episodes of acute chest syndrome is an accumulating pulmonary fibrosis that decreases lung compliance.