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[Comparative analysis of conventional pulmonary function test results in children with asthma or cough variant
Jie Yuan1, Shu-Hua An, Wen-Jie Gao
1Children's Hospital of Hebei Province, Shijiazhuang, China. mxyz2000@21cn.com
Insights
Children with acute asthma attacks show significant small and large airway dysfunction. Cough variant asthma (CVA) and asthma in remission present with mild small airway dysfunction, indicating distinct patterns in pediatric respiratory conditions.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Asthma and cough variant asthma (CVA) are common respiratory conditions in children.
- Pulmonary function tests (PFTs) are crucial for diagnosing and monitoring airway obstruction.
- Understanding PFT differences between asthma, CVA, and remission states is important for accurate diagnosis and management.
Purpose of the Study:
- To compare conventional pulmonary function test results in children diagnosed with asthma or CVA.
- To differentiate the severity and pattern of airway dysfunction in acute asthma attacks, asthma remission, and CVA.
Main Methods:
- A comparative study involving 140 children diagnosed with asthma or CVA and 30 healthy controls.
- Measurement of key pulmonary function indices including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and various forced expiratory flow rates (FEF25, FEF50, FEF75, MMEF75/25).
- Participants were categorized into acute asthma attack, asthma remission, and CVA groups.
Main Results:
- Children in acute asthma attacks exhibited significantly reduced PFT values, with marked declines in FEF50, FEF75, and MMEF75/25.
- CVA and asthma remission groups showed reduced PFT values compared to controls, particularly in small airway function (FEF75, MMEF75/25).
- Acute asthma attack group had lower PFTs than both asthma remission and CVA groups, with no significant difference between the latter two.
Conclusions:
- Acute asthma attacks in children are characterized by significant small and large airway dysfunction.
- Cough variant asthma and asthma in remission are associated with mild small airway dysfunction.
- PFTs can help distinguish between different phenotypes of pediatric asthma and CVA, guiding clinical management.
Objective:
To compare the conventional pulmonary function test results of children with asthma or cough variant asthma (CVA).
Methods:
A total of 140 children, who were diagnosed with asthma or CVA from May 2010 to May 2011, were divided into acute asthma attack (n=50), asthma remission (n=50) and CVA groups (n=40); 30 healthy children were included as a control group. The forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow after 25% of vital capacity has been expelled (FEF25), forced expiratory flow after 50% of vital capacity has been expelled (FEF50), forced expiratory flow after 75% of vital capacity has been expelled (FEF75) and maximal midexpiratory flow (MMEF75/25) were measured.
Results:
The mean percent predicted values of all the above indices were lower than 80% in the acute asthma attack group, with FEF50, FEF75 and MMEF75/25 declining markedly; the mean percent predicted values of FEF75 and MMEF75/25 were lower than 80% in the CVA group. All the pulmonary function indices in the acute asthma attack group were lower than those in the control group. The mean percent predicted values of FVC, FEV1, FEF25 and MMEF75/25 in the asthma remission and CVA groups were lower than in the control group. All the pulmonary function indices in the acute asthma attack group were lower than in the asthma remission and CVA groups, but there were no significant differences between the asthma remission and CVA groups.
Conclusions:
There is small and large airway dysfunction, particularly small airway dysfunction, in children with acute asthma attack. Children with CVA present mainly with mild small airway dysfunction, as do those with asthma in remission.
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