title: Forced expiratory flows' contribution to lung function interpretation in schoolchildren.
abstract: Forced expiratory flow (FEF) at low lung volumes are supposed to be better at detecting lung-function impairment in asthmatic children than a forced volume. The aim of this study was to examine whether FEF results could modify the interpretation of baseline and post-bronchodilator spirometry in asthmatic schoolchildren in whom forced expiratory volumes are within the normal range. Spirometry, with post-bronchodilator vital capacity within 10% of that of baseline in healthy and asthmatic children, was recorded prospectively. We defined abnormal baseline values expressed as z-scores <-1.645, forced expiratory volume in 1 s (FEV1) reversibility as a baseline increase >12%, FEF reversibility as an increase larger than the 2.5th percentile of post-bronchodilator changes in healthy children. Among 66 healthy and 50 asthmatic schoolchildren, only two (1.7%) children with normal vital capacity and no airways obstruction had abnormal baseline forced expiratory flow at 25-75% of forced vital capacity (FEF25-75%). After bronchodilation, among the 45 asthmatic children without FEV1 reversibility, 5 (11.1%) had an FEF25-75% increase that exceeded the reference interval. Isolated abnormal baseline values or significant post-bronchodilator changes in FEF are rare situations in asthmatic schoolchildren with good spirometry quality.
authors.affiliation: APHP, Allergology Dept, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Boutin
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Koskas
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Houda
authors.initials: H
authors.lastname: Guillo
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Lucia
authors.initials: L
authors.lastname: Maingot
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: La Rocca
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France.
authors.forename: Michèle
authors.initials: M
authors.lastname: Boulé
authors.affiliation: APHP, Allergology Dept, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, F-75013, Paris, France.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Just
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, EA 4064, Santé Publique et Environnement, Paris, France Mairie de Paris, Direction de l'Action Sociale de l'Enfance et de la Santé, Cellule Cohorte, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Momas
authors.affiliation: AP-HP, Hôpital d'Enfants Robert Debré, Unité d'Epidémiologie Clinique and Inserm, CIE5, Paris, France.
authors.forename: Alberti
authors.initials: A
authors.lastname: Corinne
authors.affiliation: APHP, Unité Fonctionnelle de Physiologie-Explorations Fonctionnelles Respiratoires, Hôpital d'Enfants Armand-Trousseau, Paris, France INSERM U93 Centre de Recherche Saint Antoine, Paris, France nicole.beydon@trs.aphp.fr.
authors.forename: Nicole
authors.initials: N
authors.lastname: Beydon
mesh_terms: D001249:Asthma / Q000378:metabolism* / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000502:physiology*; D008297:Male; D010641:Phenotype; D012372:ROC Curve; D012044:Regression Analysis; D015203:Reproducibility of Results; D012119:Respiration; D013147:Spirometry / Q000379:methods*; D011795:Surveys and Questionnaires; D014797:Vital Capacity
chemical_list: D001993:Bronchodilator Agents