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Negative expiratory pressure: a new tool for evaluating lung function in children?
Erich Tauber1, Tamas Fazekas, Irmgard Eichler
1Department of General Pediatrics, Vienna University Children's Hospital, Vienna, Austria.
Pediatric Pulmonology
|February 5, 2003
Summary
Negative expiratory pressure (NEP) is feasible for measuring expiratory flow in children, including those with asthma or cystic fibrosis (CF). However, high variability may limit its clinical use.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Negative expiratory pressure (NEP) technique shows flow limitation in adult COPD patients.
- NEP does not require patient cooperation, making it suitable for pediatrics.
Purpose of the Study:
- To assess the feasibility of NEP in children.
- To investigate NEP in pediatric asthma and cystic fibrosis (CF) patients.
Main Methods:
- NEP measurements (0.3-0.7 kPa) were conducted in 14 healthy children, 12 with asthma, and 17 with CF.
- Flow-volume loops were analyzed for flow limitation during tidal breathing.
- Expiratory flow at 50% of tidal volume (TEF50) was measured.
Main Results:
- NEP measurement of TEF50 is feasible in children with good reproducibility in healthy children (ICC 77%).
- Asthmatic children showed lower TEF50, which improved post-salbutamol, though size-correction is needed.
- Flow limitation was not observed via NEP in severe CF patients, requiring further study.
Conclusions:
- NEP is a feasible technique for assessing expiratory flow in children.
- High intersubject variability may restrict NEP's clinical utility despite good individual reproducibility.
- Further research is needed on NEP's application in pediatric respiratory diseases, especially CF.