Is Bronchodilation Testing Routinely Useful in All Asthmatic Children?

The reversibility of bronchial obstruction is needed to diagnose asthma. Bronchodilation (BD) testing is, therefore, used in asthma work-up. This study explored the benefit of performing BD testing in asthmatic children without bronchial obstruction. The study included 60 subjects with asthma and normal lung function, 13 (21.7%) females and 47 (78.3%) males; the mean age was 11.5 years, 26 were adolescents, and 34 were children. Lung function, symptoms, use of asthma medications, type 2 inflammation, and asthma control were assessed in all subjects. Eleven (18%) subjects positively responded to BD testing. Fifty-five percent of subjects were uncontrolled based on Global Initiative for Asthma (GINA) criteria. The multivariate analysis identified 2 factors associated with a positive response to BD testing: FEV₁ [odds ratio (OR) = 0.91) and ACT (OR = 0.79). This study showed that BD testing could give additional helpful information in clinical practice. In addition, uncontrolled asthma, based on GINA criteria, was prevalent in children with normal lung function.