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A compendium and review of pediatric pulmonary function testing assessment opportunities for asthma
Russell J Hopp1, Mark Wilson1, M Asghar Pasha2
1Department of Pediatrics, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, NE, USA.
Insights
Spirograms offer more than just FEV1 for diagnosing pediatric asthma. This review highlights underutilized spirogram data for better asthma management in children and adolescents.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Management
Background:
- Standard spirograms are crucial for diagnosing asthma and monitoring disease progression.
- Key metrics like FEV1 and its change post-bronchodilator are commonly used.
- However, other valuable data from spirograms are often underutilized in clinical practice.
Purpose of the Study:
- To review and discuss the utility of additional spirogram parameters beyond FEV1 for pediatric asthma management.
- To highlight the underutilization of comprehensive spirogram data in children and adolescents.
- To present findings from recent literature (since 2016) on pulmonary function and bronchodilator response in pediatric asthma.
Main Methods:
- Conducted a Medline search focusing on pulmonary function, bronchodilator reversibility, small airway disease, and asthma in children and adolescents.
- Included studies published since 2016 that report on bronchodilator response or pulmonary function values after albuterol in normal or asthmatic children.
- Reviewed information on pulmonary function and bronchodilator response in pediatric populations.
Main Results:
- Limited recent data (since 2016) exists specifically on FEV1 bronchodilator response in children.
- However, other pulmonary function test parameters in children have been recently documented.
- Recent literature shows considerable attention to the interpretation of other spirogram details in asthmatic children.
Conclusions:
- While new data on FEV1 bronchodilator response in normal children is scarce, other aspects of pulmonary function interpretation in pediatric asthma warrant attention.
- Comprehensive analysis of standard spirogram data can enhance pediatric asthma diagnosis and management.
- Further exploration of underutilized spirogram metrics is recommended for improved clinical decision-making.
Objective:
Standard spirograms are widely used in the respiratory disease management community to help diagnosis asthma and provide longitudinal information. Surprisingly, basic information obtained on the spirogram, beyond the FEV1 and change in FEV1 after bronchodilator is underutilized. We reviewed information on pulmonary function and bronchodilator response in children since 2016. We present here a discussion of other element of the standard spirogram that can be used for pediatric asthma management.Methods: Medline search of pulmonary function, children, adolescents, bronchodilator reversibility, small airway disease, small airway function, asthma, airflow limitation, bronchodilator response. Studies since 2016 that provide information on normal or asthmatic children bronchodilator response, and/or small airway or pulmonary function values after albuterol.
Results:
Limited data has been published on FEV1 bronchodilator response in children since 2016. Other parameters of the pulmonary function test in children have had recent documentation.
Conclusions:
New data on FEV1 bronchodilator response in normal children is limited since 2016. However, other details of pulmonary function interpretation in asthmatic children has had considerable attention, and are reviewed here.
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