{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T02:56:02Z","timestamp":1774666562188,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2005,10,21]],"date-time":"2005-10-21T00:00:00Z","timestamp":1129852800000},"content-version":"vor","delay-in-days":4160,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[1994,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In children with acute obstructive lung disease gas exchange is affected by ventilation\u2010perfusion mismatch and the degree of bronchoconstriction. Standard lung function measurements do not reflect the impairment in gas exchange. Alternatively, the effective pulmonary blood flow (EPBF), that is, the proportion of the cardiac output that is supplying well\u2010ventilated lung units, can give accurate and noninvasive estimates of ventilation\u2010perfusion mismatch. We measured EPBF with the argon freon \u221222 rebreathing technique in children with acute severe asthma to assess their response to nebulized salbutamol and to determine whether induced changes in the EPBF could be predicted from baseline measurements. Twenty\u2010four children admitted with an acute asthma attack had spirometry and triplicate EPBF measurements before and after nebulized salbutamol. Eighteen patients had repeated tests 50 days later when fully recovered; 4 patients were taking methylxanthines on at least one occasion. The mean forced expiratory volume in 1 sec (FEV<jats:sub>1<\/jats:sub>) rose from 55% of predicted to 66% after salbutamol and to 83% with recovery. The mean coefficients of variation for EPBF measurements on the three test occasions were 11.3%, 8.2%, and 9%. Except in children on methylxanthines, the EPBF values were reduced during the acute asthma attack (median, 2.53 L\/min\/m<jats:sup>2<\/jats:sup>; range, 1.99\u20133.60 L\/min\/m<jats:sup>2<\/jats:sup>) compared with paired values obtained after recovery (median, 2.89 L\/min\/m<jats:sup>2<\/jats:sup>; range, 2.2Eb4.04 L\/min\/m<jats:sup>2<\/jats:sup>) (<jats:italic>P<\/jats:italic> = 0.009). Salbutamol caused a highly significant increase in EPBF from 2.88 L\/min\/m<jats:sup>2<\/jats:sup> (range, 1.86\u20133.80) before treatment to 3.34 L\/min\/m<jats:sup>2<\/jats:sup> (range, 2.264.65) immediately afterwards (<jats:italic>P<\/jats:italic> = 0.0003). The spirometric indices did not relate to the changes in the EPBF values. However, when the effective stroke volume index was calculated in 11 patients, the changes induced by nebulized salbutamol had a significant inverse relation with the pretreatment FEV, (<jats:italic>P<\/jats:italic> = 0.61; <jats:italic>P<\/jats:italic> = 0.02). In conclusion, the argon freon\u201022 rebreathing technique can be used successfully and reproducibly to measure EPBF in children with an acute asthma attack. Except in children taking methylxanthines, EPBF during the acute attack is reduced and rises significantly after salbutamol. EPBF values after recovery were significantly higher than the presalbutamol values during the attack. Spirometric indices do not relate to the EPBF changes but are inversely related to the effective stroke volume changes. <jats:bold>Pediatr Pulmonol. 1994; 17:370\u2013377.<\/jats:bold> \u00a9 1994 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1950170606","type":"journal-article","created":{"date-parts":[[2007,3,6]],"date-time":"2007-03-06T19:20:09Z","timestamp":1173208809000},"page":"370-377","source":"Crossref","is-referenced-by-count":3,"title":["Effective pulmonary blood flow in children with acute asthma attack requiring hospitalization"],"prefix":"10.1002","volume":"17","author":[{"given":"Panayiotis K.","family":"Yiallouros","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony D.","family":"Milner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,10,21]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/137.5.1055"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.3.605"},{"key":"e_1_2_1_4_2","first-page":"888","article-title":"Ventilation\u2010perfusion relationships during exercise induced asthma in children","volume":"130","author":"Freyschuss U","year":"1984","journal-title":"Am Rev Respir Dis."},{"key":"e_1_2_1_5_2","first-page":"888","article-title":"Ventilation\u2010perfusion mismatching in acute severe asthma: Effects of salbutamol and 100% oxygen","volume":"130","author":"Ballester E","year":"1984","journal-title":"Thorax."},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.96.5.976"},{"key":"e_1_2_1_7_2","first-page":"511","article-title":"Ventilation\u2010perfusion inequality in asymptomatic asthma","volume":"118","author":"Wagner PD","year":"1978","journal-title":"Am Rev Respir Dis."},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1974.36.5.588"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1959.14.4.541"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1159\/000193590"},{"key":"e_1_2_1_11_2","first-page":"296","article-title":"Diffusing capacity, capillary blood volume, pulmonary tissue volume and cardiac output measured by rebreathing technique","volume":"31","author":"Sackner MA","year":"1974","journal-title":"Am Rev Respir Dis."},{"key":"e_1_2_1_12_2","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1152\/jappl.1976.41.3.433","article-title":"Estimation of cardiac output by a nitrous oxide rebreathing method in adults and children","volume":"41","author":"Zeidifard E","year":"1976","journal-title":"J Appl Physiol."},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-1721-1_10"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.43.12.972"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.42.8.604"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.79.5.506"},{"key":"e_1_2_1_17_2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1152\/jappl.1987.63.1.201","article-title":"Cardiac output by rebreathing in patients with cardiopulmonary diseases","volume":"63","author":"Kallay MC","year":"1987","journal-title":"J Appl Physiol."},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.44.11.930"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.43.4.276"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1915.00070240077005"},{"key":"e_1_2_1_21_2","first-page":"340","volume-title":"Lung function at different stages in life, including reference values","author":"Cotes JE","year":"1975"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.1950170606","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.1950170606","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T21:50:39Z","timestamp":1698184239000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.1950170606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,6]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1994,6]]}},"alternative-id":["10.1002\/ppul.1950170606"],"URL":"https:\/\/doi.org\/10.1002\/ppul.1950170606","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,6]]}}}