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Comparison of peak expiratory flow rate and forced expiratory volume in one second in histamine challenge studies in
Insights
Peak Expiratory Flow Rate (PEFR) reliably measures young children's response to inhaled histamine, correlating well with the standard FEV1 test. This makes PEFR a suitable alternative for histamine provocation studies in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Allergy and Immunology
Background:
- Performing Forced Expiratory Volume in 1 second (FEV1) is challenging in young children.
- Histamine provocation tests are crucial for diagnosing obstructive airway diseases.
Purpose of the Study:
- To evaluate Peak Expiratory Flow Rate (PEFR) as an alternative to FEV1 for histamine challenge tests in children.
- To establish PEFR's reliability in assessing airway hyperresponsiveness in pediatric populations.
Main Methods:
- A correlation analysis was conducted between FEV1 and PEFR changes in 123 children with recurrent respiratory symptoms during histamine challenge.
- Histamine provocation tests using PEFR alone were performed on 56 children unable to perform spirometry.
Main Results:
- A highly significant correlation (r = 0.83) was observed between the percentage fall in FEV1 and PEFR from baseline.
- Histamine challenge tests using PEFR alone were found to be reliable in children too young for spirometry.
- A 20% fall in either PEFR or FEV1 was established as the criterion for a positive histamine provocation test.
Conclusions:
- Peak Expiratory Flow Rate (PEFR) is an adequate and reliable measurement for histamine provocation studies in children.
- PEFR can be used interchangeably with FEV1 in pediatric histamine challenge testing.
- This facilitates the diagnosis of airway hyperresponsiveness in younger children who cannot perform spirometry.
Abstract:
The difficulty in performing FEV1 in young children prompted us to assess whether PEFR could be used to measure the response to inhaled histamine. In 123 children with recurrent respiratory symptoms we found a highly significant correlation (r = 0.83, P less than 0.001) between the percentage fall from base-line of FEV1 and PEFR. We also performed histamine challenge tests using PEFR alone on 56 children too young to manage spirometry and found our procedure reliable. PEFR is an adequate measurement in histamine provocation studies and can be used interchangeably with FEV1. The criterion for a positive test is a 20% fall in either PEFR or FEV1.