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[The value of respiratory function tests in the surveillance of asthmatic children]
C Dupont1, M T Antonini, M Denoyer
1Services de Pédiatrie, Bouquier C.H.U. Dupuytren, Limoges.
Insights
Pulmonary function testing in children with asthma can reveal obstructive airway disease even in asymptomatic cases. Early detection through spirometry indices like FEV1/VC and MMFR/VC can guide timely therapeutic interventions.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Context:
- Asthma management in children requires accurate assessment of airway obstruction.
- Pulmonary function testing (PFT) is crucial for diagnosing and monitoring asthma severity.
- Interpreting PFT results in pediatric asthma can be challenging due to varying normal values.
Purpose:
- To evaluate the utility of pulmonary function testing (PFT) in identifying obstructive airway disease in asthmatic children between exacerbations.
- To classify asthmatic children into distinct groups based on PFT-derived obstructive indices (FEV1/VC and MMFR/VC).
- To correlate clinical asthma severity with PFT findings and assess the need for pharmacological treatment.
Summary:
- A study analyzed PFT data from 169 asthmatic children using VIALATTE classification, FEV1/VC, and MMFR/VC ratios.
- Children were categorized into normal, probable distal airway obstruction, and proximal/distal airway obstruction groups.
- Comparison of FEV1 and MMFR values aimed to precisely quantify obstructive disease, with 2/3 of asymptomatic children showing evidence of obstruction.
Impact:
- Findings suggest that PFT can detect subclinical obstructive disease in children with asthma.
- Identifies asymptomatic children who may benefit from early pharmacological intervention.
- Highlights the importance of standardized interpretation of PFT in pediatric asthma for effective management.
Abstract:
The purpose of pulmonary function testing in children with asthma is to search for obstructive airway disease. We examined the charts of 169 asthmatic children during intervals between acute exacerbations. The severity of asthma was determined according to VIALATTE classification, with the Tiffeneau ration FEV1/VC (1) and the MMFR/VC ratio serving as obstructive indices. According to these data, children were classified into three groups: normal children (normal FEV1/VC and MMFR/VC), children with probable obstruction of the distal airways (normal FEV1/VC and decreased MMFR/VC), and children with both proximal and distal airway obstruction (decreased FEV1/VC and MMFR/VC). Since suggested normal values vary in the literature, we compared FEV1 and MMFR to determine as accurately as possible the number of children with obstructive disease. The relationship between the degree of clinical involvement and pulmonary function testing results was studied. Clinically, asymptomatic children with suspected normal respiratory function had evidence of obstructive disease in two out of three cases, and would benefit from drug therapy.