Baseline peak expiratory flow rate and post-exercise peak expiratory flow rate: What is better in the functional assessment of the pediatric patient with asthma?

Abstract

Objective: This is a research study which purpose was to determine if the Post-exercise peak expiratory flow rate, is more useful in the functional assesment of the pediatric patient diagnosed with asthma than the Baseline peak expiratory flow rate.

Materials and methods: 318 children entered to the study, who successfully completed the exercise bronchial challenge test as part of their initial clinical assesment of the Asthma Program at Yanahuara III Hospital. In which it was compared the baseline PEFR with the lowest PEFR post-exercise after the test was completed.

Results: It was observed that the average baseline PEFR was 266,61 L/min, being its percentage of adequacy of a 84,58% with respect to the theoretical PEFR (315,21 L/min) . On the other hand the average post-exercise PEFR was 199,63 L/min, being the average fall of PEFR -25,12% regarding the basal register. Considering that the cut-off points to consider altered the baseline PEFR are lower than 80% from the theoretical value, and for the exercise bronchial challenge test the PEFR fall must be greater than 11%. We found that 30,82% of the children had a baseline PEFR score below 80%, while 82,39% of the children studied had a PEFR drop above 11% with statistical difference (p < 0,01).

Conclusions: The Post-exercise PEFR is more useful in the initial assessment of the child with asthma than the Baseline PEFR and recomends its routine use in any child suspected of bronchial asthma with an age greater than 5 years.