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Assessing bronchodilator responsiveness in infants using partial expiratory flow-volume curves
Shahid Sheikh1, Robert Castile, John Hayes
1Section of Pulmonary Medicine, Department of Pediatrics, Children's Hospital, Ohio State University, Columbus, Ohio, USA. SheikhS@pediatrics.ohio-state.edu
Pediatric Pulmonology
|August 12, 2003
Summary
The FEF(75)/FEF(peak) measure is more effective than V
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Infant Lung Function Testing
Background:
- Wheezing in infants is a common clinical problem.
- Accurate assessment of airway function is crucial for diagnosis and management.
- Bronchodilator responsiveness is a key indicator of reversible airway obstruction.
Purpose of the Study:
- To compare the effectiveness of two lung function measures, maximum forced expiratory flow at functional residual capacity (V'maxFRC) and the ratio of flow at 75% of forced expiratory volume to peak flow (FEF(75)/FEF(peak)).
- To determine which measure better detects bronchodilator-induced changes in wheezy infants.
Main Methods:
- Evaluated 55 infants with recurrent wheezing (mean age 7.8 months).
- Measured V'maxFRC and FEF(75)/FEF(peak) at baseline and 15 minutes post-albuterol via partial expiratory flow-volume curves.
- Quantified measure effectiveness using relative effect size (mean difference divided by standard deviation of differences).
Main Results:
- FEF(75)/FEF(peak) showed a significantly greater mean percent change (44.1%) post-albuterol compared to V'maxFRC (18.3%).
- The relative effect size for FEF(75)/FEF(peak) was 1.20, substantially higher than for V'maxFRC (0.47).
- Changes in FEF(75)/FEF(peak) were significantly more pronounced (P < 0.0001) following bronchodilator administration.
Conclusions:
- FEF(75)/FEF(peak) is a more sensitive indicator of bronchodilator response in wheezy infants than V'maxFRC.
- This finding aids in the objective assessment of airway function and reversibility in infants.
- FEF(75)/FEF(peak) offers improved diagnostic utility for evaluating obstructive airway diseases in young children.
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