Pulmonary Function In Asthmatic Children Research Articles

Monitoring ambient air pollution and pulmonary function in asthmatic children by mobile applications in COVID-19 pandemic.

Several public health measures were implemented during the COVID-19 pandemic. However, little is known about the real-time assessment of environmental exposure on the pulmonary function of asthmatic children. Therefore, we developed a mobile phone application for capturing real-time day-to-day dynamic changes in ambient air pollution during the pandemic. We aim to explore the change in ambient air pollutants between pre-lockdown, lockdowns, and lockdowns and analyze the association between pollutants and PEF mediated by mite sensitization and seasonal change. A prospective cohort study was conducted among 511 asthmatic children from January 2016 to February 2022. Smartphone-app used to record daily ambient air pollution, particulate matter (PM2.5, PM10) Ozon (O3), nitrogen dioxide (NO2), Carbon Monoxide (CO), sulfur dioxide (SO2), average temperature, and relative humidity, which measured and connected from 77 nearby air monitoring stations by linking to Global Positioning System (GPS)-based software. The outcome of pollutants' effect on peak expiratory flow meter (PEF) and asthma is measured by a smart peak flow meter from each patient or caregiver's phone for real-time assessment. The lockdown (May 19th, 2021, to July 27th, 2021) was associated with decreased levels of all ambient air pollutants aside from SO2 after adjusting for 2021. NO2 and SO2 were constantly associated with decreased levels of PEF across lag 0 (same day when the PEF was measured), lag 1 (one day before PEF was measured), and lag 2 (two days prior when the PEF was measured. Concentrations of CO were associated with PEF only in children who were sensitized to mites in lag 0, lag 1, and lag 2 in the stratification analysis for a single air pollutant model. Based on the season, spring has a higher association with the decrease of PEF in all pollutant exposure than other seasons. Using our developed smartphone apps, we identified that NO2, CO, and PM10 were higher at the pre-and post-COVID-19 lockdowns than during the lockdown. Our smartphone apps may help collect personal air pollution data and lung function, especially for asthmatic patients, and may guide protection against asthma attacks. It provides a new model for individualized care in the COVID era and beyond.

Effects of acupoint herbal patching as an add-on to asthma medication during Sanfu days, as the hottest days in summer, on the acute attack, the immunological response, and the pulmonary function in asthmatic children: A meta-analysis.

Background:A meta-analysis was performed to evaluate the effect of acupoint herbal patching as an add-on to asthma medication during Sanfu days, as the hottest days in summer, on the acute attack, immunological response, and the pulmonary function in asthmatic children.Methods:A systematic literature search up to July 2021 was performed and 13 studies included 1166 asthmatic children at the start of the study; 587 of them were using acupoint herbal patching as an add-on to asthma medication during Sanfu days and 579 were given asthma medication only.Results:Acupoint herbal patching as add-on to asthma medication had significantly lower frequency of acute attack (mean difference [MD], –1.57; 95% confidence interval [CI], –2.28 to –0.85, P < .001), lower asthma relapse (odds ratio, 0.13; 95% CI, 0.04–0.43, P < .001), and higher forced expiratory volume in 1 second (MD, 1.72; 95% CI, 0.89–2.65, P < .001), higher peak expiratory flow rate (MD, 1.15; 95% CI, 0.37–1.93, P = .004), lower immunoglobulin E after treatment (MD, –123.81; 95% CI, –185.60 to –62.02, P < .001), and higher interferon-gamma after treatment (MD, 7.17; 95% CI, 2.42–11.92, P = .003) compared to asthma medication only in asthmatic children.Conclusions:Acupoint herbal patching as an add-on to asthma medication during Sanfu days had a significantly lower frequency of acute attack, lower asthma relapse, higher forced expiratory volume in 1 second, higher peak expiratory flow rate, and higher interferon-gamma after treatment in asthmatic children compared to asthma medication only in asthmatic children.

The effect of 16 Arg/Gly β2–adrenergic receptors gene polymorphism on pulmonary function in asthmatic children treated with nebulized salbutamol

Background: The β2-adrenergic receptor gene is a typical candidate for the study of genetic polymorphism, the biological relevance, and clinical consequences of polymorphisms. Many patients with asthma do not respond to β2-agonist; in addition, a wide interindividual variability in pharmacological response exists, likely because of the interaction between clinical, environmental, and genetic factors. Methods: A total of 80 asthmatic children, including 55 males and 25 females with acute attacks ages range between 5 and 18 years, attended the Respiratory Clinic at Karbala Pediatric Hospital, allele-specific polymerase chain reaction was performed to determine SNP of β2-adrenergic receptor gene at nucleic acid 46 (16 amino acid position). Results: Asthmatic children having GG genotype showed significant increase (P < 0.05) in all the recorded lung function parameter (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], FEV1/FVC and FEV1% predicted) after treatment with nebulized salbutamol while those having AA and AG genotypes showed significant (increase) improvement (P < 0.05) only in FEV1, FVC, and FEV1% predicted after treatment with nebulized salbutamol and showed no significant increase (P > 0.05) in FEV1/FVC ratio after treatment with nebulized salbutamol, patients having GG genotype of 16Arg/Gly SNP showed highest change (increase) in FEV1 (204.44 ± 175.35) ml and in FEV1% predicted (15.22 ± 14.75) % after treatment with nebulized salbutamol in compared with other genotypes groups, although this change is not statistically significant (P > 0.05). Conclusion: Asthmatic children having GG (Gly16Gly) genotype showed better improvement in lung function after nebulized salbutamol in compared with those having AA (Arg16Arg) and those having heterozygous AG (Arg16Gly) during mild-to-moderate acute asthma attacks.

Impact of 27gln\glu polymorphisms of β2-adrenergic receptor gene on pulmonary function in asthmatic children treated with nebulized salbutamol

Impact of 27gln\glu polymorphisms of β2-adrenergic receptor gene on pulmonary function in asthmatic children treated with nebulized salbutamol

Sufficient vitamin D status positively modified ventilatory function in asthmatic children following a Mediterranean diet enriched with fatty fish intervention study

Asthma in children is the most prevalent allergic disease worldwide that has become a major public health priority. The objective of this study was to examine the relationship between baseline serum vitamin D status, spirometry, and fractional exhaled nitric oxide levels (FeNO) in 64 Greek children with ‘mild asthma’ aged 5 to 12 years (51.6% male) in a dietary intervention study. We hypothesized that baseline serum vitamin D levels modify the beneficial response of fatty fish intake on pulmonary function in asthmatic children following a Mediterranean diet. The intervention group consumed 2 fatty fish meals/week (≥150 g cooked filleted fish/meal) as part of the Mediterranean diet for six months, and the control group consumed their usual diet. Baseline serum 25(OH)D was determined using enzyme-linked immunoassay and defined as sufficient levels of 25(OH)D ≥25 ng/mL. Only 36% of children were graded as sufficient in 25(OH)D levels on entry into the study with a higher proportion of girls insufficient than boys (61% vs 39% respectively). Participants with sufficient levels of serum 25(OH)D at baseline, consuming the intervention diet increased FEV1/FVC by 4.89 units (β = 4.89; 95%CI: 1.19-8.61; p = 0.013) and FEF25-75% by 12.83 units (β = 12.83; 95%CI: 4.27-21.40; p = 0.006) compared to controls. No significant differences in pulmonary function or FeNO were observed for those with insufficient levels of 25(OH) D in the intervention or control groups. In conclusion, sufficient serum vitamin D levels enhanced ventilatory function in response to a dietary intervention in asthmatic children.

Association of Dyslipidemia and Pulmonary Function in Asthmatic Children

Association of Dyslipidemia and Pulmonary Function in Asthmatic Children

Effect of obesity on pulmonary function in asthmatic children of different age groups

To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (<6 years) and school-age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests [forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests [maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (P<0.05) after adjustment for sex and BMI. The normal-weight children in the school-age group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (P<0.05). The overweight children in the school-age group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (P<0.05). The effect of obesity on the pulmonary function varies with age in children with asthma, and the effect is more obvious in those of preschool age.

Effect of Obesity on Pulmonary Function in Children with Mild Persistent Asthma

Objective: The prevalence of asthma is increased in obese individuals. There is no concrete evidence that an increase in body mass index is associated with a loss of pulmonary function in childhood asthma. Our aim was to investigate the effect of obesity, atopy, and sex on pulmonary function in asthmatic children. Materials and Methods: This study is a cross-sectional analysis in children with mild persistent asthma. A total of 76 obese and 55 lean children with asthma were recruited. All of the participants were assessed by pulmonary function tests. Skin prick tests including common aeroallergens were performed to all patients. Results: No differences were found in pulmonary function test parameters between obese and lean patients with asthma. In obese patients with asthma, the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) was significantly lower in nonatopic (92.1±6.4) than in atopic patients (95.5±5.3, p=0.02). We also demonstrated that FEV1/FVC was significantly lower in nonatopic obese patients (92.1±6.4) than in nonatopic lean patients with asthma (95.6±4.7, p=0.05). Conclusion: Obesity does not seem to be affecting pulmonary function in children with well-controlled mild persistent asthma. However, airways of nonatopic obese asthmatics are negatively affected.

Asma y ejercicio: Revisión bibliográfica

Patients with asthma may show lower exercise tolerance due to asthma symptoms during exercise and/or exercise-induced asthma and other reasons, such as lack of fitness due to inactivity. Some may also restrict physical activities misconceptions about exercise and asthma in education centers, family and environment which may limit the development of the child. The evidence indicates that aerobic exercise improves aerobic capacity in asthmatic children and adolescents and can provide normal, similar to healthy patients, levels of aerobic capacity in this population. Advances in cardio-respiratory fitness are beneficial for the prevention of several concomitant diseases of childhood asthma, as obesity and mental disorders. As to the effects of physical training on pulmonary function in asthmatic children and adolescents, despite the existence of evidence of improvement in some reviews, most studies have not shown a significant change in spirometric markers of obstructive lung diseases. The major benefit of the exercise in asthmatic patients is in the quality of life, as associated with a significant improvement in quality of life (scores Pediatric Asthma Quality of Life Questionnaire, PAQLQ) in all areas evaluated (activity, symptoms and emotional function), according to various reviews. The aim of this review is to evaluate the effects of exercise in asthmatic patients and to give recommendations based on this evidence.

Reduced medication use and improved pulmonary function with supplements containing vegetable and fruit concentrate, fish oil and probiotics in asthmatic school children: a randomised controlled trial

Dietary pattern changes may be one of the key factors associated with increasing asthma prevalence. Observational studies have found negative associations between fruit, vegetable and fish consumption and risk of asthma. Experimental studies have also shown that probiotics can modulate the immune system. However, each dietary component exhibits a modest effect. The objective of the present study was to investigate the joint effect of multiple beneficial dietary components on asthma. We designed a 16-week school-based double-blind placebo-controlled randomised trial. The supplement group received fruit plus vegetable concentrate, fish oil and probiotics (FVFP supplement), while the control group received placebos. A total of 192 asthmatic children aged 10-12 years were recruited from elementary schools in metropolitan Taipei. Pulmonary function, medication usage, Paediatric Asthma Quality of Life Questionnaire (PAQLQ) score and the Childhood Asthma Control Test score were evaluated at baseline, and at weeks 8 and 16. Compared with the placebo group, the supplement group showed significant improvement in pulmonary function parameters (91 v. 178 ml for forced vital capacity (FVC), 40 v. 107 ml for forced expiratory volume in 1 s (FEV1) and 1·6 v. 4·8 % for FEV1:FVC ratio; all P values < 0·01) and had a significantly reduced proportion of those using short-acting inhaled bronchodilators and inhaled corticosteroids. However, the PAQLQ score and the Childhood Asthma Control Test score were not significantly different between the two groups, possibly because the majority of the children were treated routinely. FVFP supplements reduced medication use and improved pulmonary function in asthmatic children. The present study supports an adjuvant intervention with a combination of fruit, vegetable, fish and probiotic foods.

Air Pollution and Pulmonary Function in Asthmatic Children

Prenatal and early life periods represent critical windows for oxidant pollutant-induced lung remodeling. The objective of this study was to examine the association of prenatal and lifetime exposures to air pollutants with pulmonary function in a cohort of children with asthma. Prenatal and lifetime exposure to several air pollutants was reconstructed for 232 children with asthma from the San Joaquin Valley of California, USA. Prenatal and lifetime residences were geocoded. We obtained data on monthly average ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), and particulate matter with a median aerodynamic diameter <10 microm (PM10) concentrations. Metrics were created for key developmental periods. Predictive models were developed for 8 pulmonary function measures. A newly-developed stepwise model selection procedure-the Deletion/Substitution/Addition algorithm-was implemented and results were compared with those obtained using traditional stepwise methods. Second-trimester exposure to NO2 negatively affected forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), and first trimester exposure to PM10 negatively affected peak expiratory flow (PEF) rate. Exposure to CO in early years of life also had a negative effect on FEV1/FVC and forced expiratory flow between 25% and 75% of FVC (FEF25-75)/FVC. Second trimester exposure to PM10 and exposure to CO in the first 6 years of life had negative effects on forced expiratory flow at 25% of FVC. Prenatal, but not trimester-specific, exposure to CO was negatively associated with FEF25-75. Effects were limited to subgroups, such as children who were African American, those diagnosed with asthma before the age of 2 years, and those exposed to maternal smoking during pregnancy. Prenatal and early-life exposures to CO, PM10, and NO2 have a negative effect on pulmonary function in subgroups of asthmatic children.

Once versus twice daily budesonide metered-dose inhaler in children with mild to moderate asthma: effect on symptoms and bronchial responsiveness

Background Simplifying dosing regimens could improve both adherence and asthma-related morbidity. However, there is little information on the effectiveness of once-daily budesonide, administered through a metered dose inhaler (MDI) plus spacer, on asthma symptoms and pulmonary function in asthmatic children. Methods The aim of this study was to compare the effect of once-daily versus twice-daily doses of inhaled budesonide on symptoms, lung function and bronchial hyperresponsiveness (BHR) in asthmatic children. This study was a randomized, single-blind, parallel clinical trial. Patients received budesonide from an MDI either 800 μg as a daily dose or fractionated in 400 μg twice a day for 12 weeks. Statistical analysis was performed using tests for independent and paired samples. Results In both groups, asthma symptoms significantly decreased. However, the improvement in asthma symptoms, decrease in BHR and treatment adherence were significantly greater in the once-daily group than in the twice-daily group (p < 0.05). No significant differences were found between the two groups in spirometric parameters, morning peak expiratory flow or plasma cortisol values. Conclusions Once-daily administration of 800 μg of inhaled budesonide administered by MDI plus spacer was more effective in controlling symptoms and improving BHR than fractionating the dose to 400 μg twice daily. The differences observed in this study could have been due to the greater adherence to treatment in patients in the once-daily group.

Correlation between inhalant allergen-specific IgE and pulmonary function in children with asthma

Sensitization to aeroallergens is associated with diminished lung function in adults. Little has been studied on the relationship between the inhalant allergen-specific IgE and pulmonary function in asthmatic children. This study was focused on four major inhalant allergens found in Korea, including Dermatophagoides pteronyssinus (Der p.), Dermatophagoides farinae (Der f.), and Alternaria- and German cockroach-specific IgEs, with evaluation of pulmonary function in relation to the amount of allergens. The parents or legal guardians of participants enrolled in this study gave informed consent. Fifty-five asthmatic patients and 48 nonasthmatic children were included. The amounts of specific IgE for the four specified inhalant allergens were determined by employing the CAP system FEIA. Forced expiratory volume in 1 sec (FEV(1))/forced vital capacity (FVC), FEV(1), and forced expiratory flow between 25% and 75% of FVC (FEF(25-75)) of subjects were evaluated through pulmonary function tests. In the asthmatic group, FEV(1), FEV(1)/FVC, and FEF(25-75) were significantly reduced (P < 0.05): reduction in FEV(1) (r = -0.44) and FEF(25-75) (r = -0.33) in association with the Der f.-specific allergen, and reduction in FEV(1) (r = -0.37) and FEF(25-75) (r = -0.34) in association with the Der p.-specific allergen, were observed. However, there was no significant correlation with German cockroach and Alternaria allergen. In the control group, no significant correlation was detectable between the allergen-specific IgE titers and the results of pulmonary function tests. In asthmatic patients, Der p.- and Der f.-specific IgEs, and not German cockroach and Alternaria, seem to play a considerable role in reduced pulmonary function among asthmatic children.

Pediatric Asthma: An Approach to Pharmacogenetics Analysis

Numerous studies have clearly demonstrated that inhaled glucocorticoids alleviate clinical symptoms, improve pulmonary function, and reduce airway inflammation; there is some evidence that they may alter disease progression. Current guidelines identify inhaled glucocorticoids as the “preferred” long-term controller asthma medication, especially for moderate and severe persistent asthma. 1 Global Initiative for Asthma Global strategy for asthma management and prevention: NHLBI/NIH workshop report. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD1995 Google Scholar 2 National Asthma Education and Prevention Program Expert panel report 2: Guidelines for the diagnosis and management of asthma. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD1997 Google Scholar Clinical observations suggest that the response to inhaled glucocorticoids is highly dependent on the time of intervention: the earlier used, the more efficacious 3 Agertoft L Pedersen S Effects of long term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children. Respir Med. 1994; 88: 373-381 Abstract Full Text PDF PubMed Scopus (704) Google Scholar ; however, it is also clear that the response to inhaled glucocorticoids can vary among patients with some patients being considered “steroid resistant.” 4 Leung DYM Spahn JD Szefler SJ Steroid-resistant asthma: new insights and implications for management. in: Szefler SJ Leung DYM Severe asthma: a multidisciplinary approach. 2nd ed. Marcel Dekker, New York, NY2001: 597-619 Google Scholar

Influence of Specific Emotional States on Autonomic Reactivity and Pulmonary Function in Asthmatic Children

Research relating depression/hopelessness to cholinergic activation suggests the hypothesis that sad emotional states evoke patterns of autonomic reactivity that predispose to cholinergically mediated airway constriction in asthma. A corollary hypothesis is that positive (e.g., happy) emotional states evoke opposing effects. The purpose of the current study is to assess whether specific emotional states (sadness and happiness) can be reliably induced, physiologically differentiated, and related to asthma-relevant physiologic (autonomic) reactivity and pulmonary function in asthmatic children. Twenty-four children, aged 8 to 17 years, with moderate to severe asthma, viewed the movie E.T., The Extra-Terrestrial while having their heart and respiration rate and oxygen saturation continuously recorded. Specific scenes were identified and preselected to evoke sadness, happiness, and a mixture of happiness and sadness. Self-report of emotion and indices of physiologic response were analyzed for these targeted scenes. Sadness was associated with greater heart rate variability and instability of oxygen saturation compared with happiness, with mixed results for mixed happiness and sadness. Results support sadness as evoking patterns of autonomic influence consistent with cholinergically mediated airway constriction. Happiness appears to effect autonomic patterns that would tend to relieve airway constriction.

Psychophysiologic Reactivity in Asthmatic Children: A Cholinergically Mediated Confluence of Pathways

The purpose of this study was to determine the suitability of a newly developed experimental paradigm, designed to assess relationships among emotional responsivity, physiologic (autonomic) reactivity, airway reactivity, and pulmonary function in asthmatic children under controlled conditions of ecologically valid emotional stimulation. Twenty-four children, aged 8 through 17, with moderate to severe asthma viewed the movie, E.T., the Extra-Terrestrial, while having their heart and respiration rate and oxygen saturation continuously measured and recorded. Airway reactivity was assessed by the methacholine challenge test, and pre- and postmovie pulmonary function by spirometry. Self-report of emotion was recorded for targeted scenes. Findings indicated that emotional responsivity and physiologic reactivity to the movie were associated with increased airway reactivity and with decreased pulmonary function. The pattern of results suggests cholinergically mediated psychophysiologic pathways of emotional influence in the asthmatic process for some asthmatic children. A heuristic biopsychosocial model of these pathways is presented.

Effects of long-term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children

In a controlled prospective study we have measured growth and pulmonary function in children with asthma during long-term treatment with inhaled budesonide and compared these findings with those obtained from children not treated with corticosteroids. Two hundred and sixteen children were followed at 6 monthly intervals for 1–2 years without inhaled budesonide and then for 3–6 years on inhaled budesonide. Sixty-two children treated with theophylline, β 2-agonists and sodiumcromoglycate but not with inhaled steroids were also followed for 3–7 years (controls). During the period of budesonide therapy the mean daily dose decreased from 710 to 430 μg ( P<0·01) and no signs of tachyphylaxis to the treatment were seen. Budesonide treatment was associated with a significant reduction in the number of annual hospital admissions due to acute severe asthma (from 0·03 to 0·004 per child, P<0·001). In patients not treated with budesonide an annual decrease in % predicted FEV 1 of 1–3% was seen. In contrast FEV 1 improved significantly with time during budesonide treatment, both compared with the run-in period and with the control group ( P<0·01). Furthermore, there was a significant ( P=0·01) relationship between the duration of asthma at the start of budesonide and the annual increase in FEV 1 during budesonide therapy. After 3 years of treatment with budesonide, children who started this therapy later than 5 years after the onset of asthma had significantly lower FEV 1 (96%) than the children who received budesonide within the first 2 years after the onset of asthma (101%) ( P<0·05). No statistically significant changes in growth velocity (run-in=5·6 cm year −1, controls=5·6 cm year −1, budesonide=5·5 cm year −1) or weight gain (run-in=3·5 kg year −1, controls=3·6 kg year −1, budesonide=3·6 kg year −1) were seen during budesonide treatment. We conclude that inhaled budesonide in doses up to 400 μg per day does not stunt growth in children with asthma and that early intervention with this treatment may prevent the development of irreversible airway obstruction and reduce the risk of under-treatment. Finally, continuous long-term treatment is not associated with the development of tachyphylaxis.

Quantitative gastroesophageal reflux and pulmonary function in asthmatic children and normal adults receiving placebo, theophylline, and metaproterenol sulfate therapy

There is evidence that theophylline therapy inhibits lower esophageal sphincter pressure and enhances gastroesophageal reflux in normal adults and adult asthmatics. No studies have used intraesophageal pH monitoring to assess the effect of bronchodilators over prolonged periods. With the use of the latter procedure, we studied 10 randomly selected chronic asthmatic children (mean age 10.6 yr) and 10 normal adult subjects; all subjects were without clinical symptoms of GER. In this single-blind study, all subjects were evaluated for GER during three separate 24-hr periods while they were receiving oral doses of placebo, theophylline, and metaproterenol sulfate therapy. No significant increase of GER was found in asthmatic subjects or normal subjects on either drug. No adverse correlation of GER and pulmonary function was noted in either group. Asthmatic subjects and normal subjects had asymptomatic or "silent" physiologic GER during sleep and in the 2-hr postprandial period. This study confirms that in chronic asthmatic children standard oral bronchodilator therapy does not adversely affect "silent" GER or pulmonary functions.

Studies of Pulmonary Function in Asthmatic Children

AbstractPulmonary functions were studied in 188 asymptomatic children with bronchial asthma and 272 healthy children. Ventilatory function was measured by the spirogram and maximum expiratory flow volume (MEFV) curve. Although the forced vital capacity (FVC) and peak expiratory flow rate (PEFR) were of the same values in normal and asthmatic subjects, the maximal mid‐expiratory flow rate (MMF), the maximal flow rate at 50% (V50) and that at 25% (V25) of vital capacity were definitely lower in asthmatic children than those in healthy children, particularly in children with severe asthma.Arterial blood gas tensions and pH were measured in 180 asthmatic children with various clinical symptoms and 102 asthmatic children with disturbance of consciousness. Hypocapnia was detected even in the asymptomatic state, and carbon dioxide tensions (Pco2) were markedly high values only on very severe attacks. There was a linear fall in arterial oxygen tension (Po2) and oxygen saturation (So2) with increasing severity of attack. A complication of metabolic acidosis was frequent in the subjects who suffered from severe attacks.Children with severe asthma had small airways obstruction even in the asymptomatic state. This pulmonary disturbance appears to induce mild sustained hypocapnia and respiratory alkalosis as acceleration of ventilatory drive. Therefore, the development of hypercapnia, even if it is mild, may be considered to represent somewhat severe impairement of the pulmonary function in children with bronchial asthma.

235 The spectrum of antihistamines adversely affecting pulmonary function in asthmatic children

235 The spectrum of antihistamines adversely affecting pulmonary function in asthmatic children