fev 25-75 measuring below normal

[edan]

Hi everyone. I was going over my daughter's clinic files. I knew of this before but reviewing it has make me start thinking again.
DD is 5 1/2. Her fev1 is always measuring over 110% of predictedbut the 25-75 marker is always 85-90% of predicted. Does anyone else see this with their children and do they "grow out" of it? I.E. learn better how to do it? Her doctor has said it is still in the normal range and that she is still perfecting the pfts, but I am not so sure. Of course, I am not in la la land and realize CF is a progressive disease.
Any thoughts?
Thanks,
Edan.

 

[JENNYC]

Date FVC FEV1 FEF 25-75
September 15, 2010 1.01 0.98 1.62
December 15, 2010 1.11 0.85 0.73
March 2, 2011 1.30 1.15 1.35
June 8, 2011 1.09 0.92 0.96
June 23, 2011 1.12 1.01 1.19
July 1, 2011 1.36 1.23 1.61
September 28, 2011 1.42 1.28 1.51
November 16, 2011 1.44 1.24 1.41
February 8, 2012 1.42 1.19 1.18
March 1, 2012 1.38 1.10 1.00
March 5, 2012 1.50 1.25 1.15
March 28, 2012 1.47 1.31 1.53

I keep a chart of Abby's PFT's. I copied and pasted them here, thought this might help a little. As you can see her 25-75 bounces all over the place. I was told that the 25-75 was to tell us how her small airways are doing. Of course most of the time when they were lower she was admitted for a couple of weeks. I don't know whether this helps you or not but thought I would share in case it does. And they told me that Abby had to perfect her technique when she was younger as well. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JENNYC]

Well that didn't post to pretty did it? lol The last set of #'s is the 25-75. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[TonyaH]

Andrew is 14 and for as long as he has done pfts his small airways have typically been about 5 to 10 percent higher than his fev1. That is not to say his numbers have not fuctuated and there have been times when his small airways have been 10 percent lower than fev 1.
I think the biggest thing to remember is that pft trends are very personal. Instead of worrying about where numbers fall compared to other cfers, I would notice trends in your child's pfts and address anything that vears from those trends. In the same way, it is also important to remember that some people can have, say, a 90% fev1 and feel great, while others who are used to a 105 would feel crummy with a 90%.
This is where the individual progression of cf is so difficult to foresee...you really just have to go with the information you have in front of you and treat accordingly. (Which, I don't know about you, but as a mom, this took me a LONG time to come to terms with.)
I would say that if you are not seeing any symptoms and small airways have always been a bit lower than fev1 that that is your baseline.

 

[edan]

Thanks you two. I am going to submit another post now on how to bring the small airways up.

JennyC, out of curiosity, are those measurements in liters?

Thanks,
Edan.

 

[JENNYC]

Yes, I don't have it in front of me right now, but I'm pretty sure that it is in liters. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JustaCFmom]

Hi!
I have the same thing with my PFT's and so far I was checked for asthma (negative) and I keep bothering the doctors when I go for my kids' appointments. I did get 74 on the sweat test; their problem is that I don't have CF per se (ie. repeat infections, etc.) My VERY ATHLETIC CF son got FEV1 of 130 %ile and his 25-75 graph goes way out (vs. mine which sags).

I think that if you want to see improvement in the lower airways, it would have to be through being VERY active. What do you guys think?

 

[TonyaH]

I just had to respond and say that an fev1 of 130 is unbelievably great!! I hope you son keeps up the good work! Awesome!