Effects of time, albuterol, and budesonide on the shape of the flow-volume loop in children with asthma Anand C. Patel, MD, Mark L. Van Natta, MHS, James.

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Presentation transcript:

Effects of time, albuterol, and budesonide on the shape of the flow-volume loop in children with asthma Anand C. Patel, MD, Mark L. Van Natta, MHS, James Tonascia, PhD, Robert A. Wise, MD, Robert C. Strunk, MD Journal of Allergy and Clinical Immunology Volume 122, Issue 4, Pages 781-787.e8 (October 2008) DOI: 10.1016/j.jaci.2008.08.010 Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Prebronchodilator (A) and postbronchodilator (B) MEFVL curves with tangent (dV˙/dV) and chord (V˙/V) lines (broken and solid lines, respectively) fitted at 50% FVC. The ratio of their slopes, (dV˙/dV)/(V˙/V), defines the SR at 50% FVC. Note that as the MEFVL curve becomes more linear after bronchodilator (Fig 1, B), the 2 slopes become more similar, and SR decreases towards 1, where the slopes are equal. Journal of Allergy and Clinical Immunology 2008 122, 781-787.e8DOI: (10.1016/j.jaci.2008.08.010) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Effects of time and bronchodilator on SR in the placebo group. The placebo group's SR61 (A) and SR35 (B) before (magenta) and after (blue) bronchodilator are plotted. P values on the graph reflect comparisons of prebronchodilator SR61 and SR35 between time points as marked. ∗The mean changes before to after bronchodilator for SR61 and SR35 are greater than 0 at all time points (P < .0001). BL, Baseline. Journal of Allergy and Clinical Immunology 2008 122, 781-787.e8DOI: (10.1016/j.jaci.2008.08.010) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Effects of bronchodilator on SR. Changes in SR61 (A) and SR35 (B) with bronchodilator ([Postbronchodilator SR] − [Prebronchodilator SR]) for budesonide (Bud)– and placebo (Plb)–treated patients. Comparisons between the placebo- and budesonide-treated groups at marked time points were all statistically insignificant for both postbronchodilator/prebronchodilator SR61 and SR35. The mean postbronchodilator/prebronchodilator SR61 and SR35 are greater than 0 at all time points (P < .0001). Journal of Allergy and Clinical Immunology 2008 122, 781-787.e8DOI: (10.1016/j.jaci.2008.08.010) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Effects of time, bronchodilator, and budesonide on SR. Prebronchodilator values (solid lines) for SR61 (A) and SR35 (C) and postbronchodilator values (dashed lines) for SR61 (B) and SR35 (D) are plotted for both budesonide-treated (squares) and placebo-treated (triangles) patients. ∗P values reflect significance of comparison at the end of the study between budesonide- and placebo-treated patients adjusted for changes from baseline. Journal of Allergy and Clinical Immunology 2008 122, 781-787.e8DOI: (10.1016/j.jaci.2008.08.010) Copyright © 2008 American Academy of Allergy, Asthma & Immunology Terms and Conditions