Home spirometry and asthma severity in children.

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Asthma Research

Background:

• Peak expiratory flow (PEF) monitoring in childhood asthma is debated due to unreliable paper diaries.
• Electronic spirometry offers automatic data storage, potentially improving home monitoring accuracy.

Purpose of the Study:

• To assess the correlation between home spirometry (PEF and FEV1) variations and other asthma severity markers in children.
• To evaluate the utility of electronic home spirometry in managing mild-to-moderate persistent childhood asthma.

Main Methods:

• 36 children with mild-to-moderate persistent asthma used electronic home spirometers twice daily for 3 months.
• Recorded PEF and forced expiratory volume in one second (FEV1) electronically, alongside a written asthma severity score.
• Assessed bronchial responsiveness, bronchodilator response, and asthma-specific quality of life.

Main Results:

• Variations in PEF showed weak correlations with bronchial responsiveness and bronchodilator response.
• No significant correlation was found between PEF variations and asthma severity scores or quality-of-life scores.
• Within-individual correlations between home spirometry indices and other asthma markers were highly variable.

Conclusions:

• Home spirometry (PEF and FEV1) shows poor concordance with other indices of asthma activity in children.
• The variability limits the clinical usefulness of home spirometry for monitoring childhood asthma.
• Electronic monitoring does not fully overcome the limitations of traditional PEF diaries.