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Pulmonary Function Tests in Childhood Asthma: Which indices are Better for Assessment of Severity?
Puneeth H R1, C A Gopalakrishna Mithra1, Vinod H Ratageri2
1Department of Pediatrics, Karnataka Institute of Medical Sciences, Hubli, Karnataka, 580021, India.
Insights
Pulmonary function tests in childhood asthma reveal that FEV1 is the best indicator for assessing asthma severity. FEF25-75 is more effective for predicting mild asthma cases.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Research
Background:
- Childhood asthma management requires accurate assessment of disease severity.
- Pulmonary function tests (PFTs) are crucial for evaluating respiratory health in children.
- Identifying sensitive PFT indices aids in effective asthma classification and treatment.
Purpose of the Study:
- To investigate pulmonary function test (PFT) parameters in children with asthma.
- To determine the most effective PFT indices for assessing asthma severity.
- To identify spirometric measures that best predict mild asthma.
Main Methods:
- A cross-sectional study involving 144 children aged 5-15 years with mild and severe persistent asthma.
- Exclusion of children with doubtful asthma diagnosis or other chronic lung diseases.
- Detailed spirometry performed using RMS HELIOS 401, with age/sex-matched controls.
Main Results:
- All studied PFT indices (FEV1, FVC, FEV1/FVC, FEF25-75, PEFR) decreased with increasing asthma severity.
- FEV1 showed the highest correlation coefficient (-0.652) with asthma severity.
- FEF25-75 demonstrated a higher area under the curve, indicating better prediction of mild asthma.
Conclusions:
- Forced Expiratory Volume in 1 second (FEV1) is a superior index for assessing asthma severity in children.
- Mid-expiratory flow rate (FEF25-75) is a more sensitive parameter for predicting mild asthma.
- These findings aid in refining diagnostic and monitoring strategies for pediatric asthma.
Objective:
To study pulmonary function tests in childhood asthma and to determine which indices are better for assessment of severity.
Methods:
This was a hospital-based, cross-sectional study. All consecutive children aged between 5 and 15 y with mild and severe persistent asthma were enrolled. Children in whom diagnosis of asthma was doubtful and those with chronic lung disease or suppurative lung disease were excluded. Diagnosis and classification was based on GINA guidelines. Age-/sex-matched controls who did not have history of wheezing any time in the past were selected. Detailed spirometry was performed on all children enrolled using RMS HELIOS 401.
Results:
A total of 144 children were enrolled in the study (48 children in each group, i.e., control, mild and severe). Mean age of the study population was 9.06 ± 2.604 y with M:F ratio of 1.9:1. Mean percent of predicted values of FEV1, FVC, FEV1/FVC, FEF25-75, and PEFR in the control group was 94.83, 92.63, 103.25, 73.90, and 93.60; in the mild group was 90.58, 83.52, 111.10, 76.50, and 92.00; and in the severe group 57.56, 62.83, 92.85, 40.15, and 62.12, respectively. Values of all the indices decreased with increase in severity. FEV1 (95% CI: 0.884 to 0.971) having the highest correlation coefficient (-0.652) with respect to severity of asthma and FEV1/FVC having the least (-0.202). FEF25-75 (95% CI: 0.652 to 0.803) having a higher area under the curve, was a better spirometric parameter in predicting mild asthma.
Conclusion:
FEV1 was better index for assessing severity of asthma and FEF25-75 better in predicting mild asthma.
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