Pediatric Pulmonology 49:1253–1254 (2014)
Letter to the Editor
Markers of Early Lung Disease: The Search Continues…
While we agree with Bakker et al.,1 that more sensitive markers of early CF lung disease are needed, we are concerned that the evidence provided to support the use of forced expiratory flows (FEF) as such a measure is fundamentally flawed. The authors conclude that FEF75 would be better at detecting small airways disease in young children based on their observations of children aged 6–20 years. However, both FEF75 and FEF25–75 are highly dependent on the accompanying FVC, which is not only more difficult to measure accurately in very young children but is frequently affected by the disease process itself, thereby reducing both the accuracy and feasibility of such measurements. The authors also conclude that FEF75 better distinguishes between healthy children and those with CF; however, the FEF75 values in healthy children
Letter to the Editor
Markers of Early Lung Disease: The Search Continues…
While we agree with Bakker et al.,1 that more sensitive markers of early CF lung disease are needed, we are concerned that the evidence provided to support the use of forced expiratory flows (FEF) as such a measure is fundamentally flawed. The authors conclude that FEF75 would be better at detecting small airways disease in young children based on their observations of children aged 6–20 years. However, both FEF75 and FEF25–75 are highly dependent on the accompanying FVC, which is not only more difficult to measure accurately in very young children but is frequently affected by the disease process itself, thereby reducing both the accuracy and feasibility of such measurements. The authors also conclude that FEF75 better distinguishes between healthy children and those with CF; however, the FEF75 values in healthy children
