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[Control status and follow-up of acute attacks in children with bronchial asthma with normal pulmonary ventilation
Lan-Lan Ma1, Ling Chen1, Qin Wang1
1Department of Pediatric Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.
Insights
Asthma control remains incomplete in one-third of school-aged children with normal lung function. Children with a lower FEV1/FVC ratio face higher risks of acute asthma attacks.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Asthma is a common chronic respiratory condition in children.
- Normal pulmonary ventilation function is often assumed to indicate good asthma control.
- However, the control status and risk of acute exacerbations in children with normal lung function require further investigation.
Purpose of the Study:
- To assess the asthma control status in school-aged children with normal pulmonary ventilation function.
- To evaluate the incidence of acute asthma attacks within a one-year follow-up period.
- To identify potential risk factors associated with poor asthma control and acute attacks.
Main Methods:
- Retrospective analysis of clinical data from 327 children (aged 6-14) with asthma and normal pulmonary ventilation.
- Children were categorized based on their one-second forced expiratory volume to forced vital capacity ratio (FEV1/FVC): ≥80% (n=267) and <80% (n=60).
- Comparison of pulmonary ventilation function, asthma control levels, and acute attack occurrence between the two groups over one year.
Main Results:
- The group with FEV1/FVC <80% exhibited lower baseline pulmonary function and a higher prevalence of small airway dysfunction compared to the ≥80% group (P<0.05).
- Despite improvements after treatment, small airway function remained lower in the <80% group. Baseline incomplete asthma control was observed in 34.6% of all children, with the <80% group showing poorer control (P<0.05).
- After one year, the <80% group continued to have lower asthma control levels and a significantly higher proportion of acute asthma attacks (P<0.05).
Conclusions:
- Approximately one-third of school-aged children with asthma experience incomplete control even with normal pulmonary ventilation function.
- Children with FEV1/FVC <80% are at an increased risk of acute asthma attacks.
- These findings underscore the need for close monitoring and intensified asthma management strategies in this subgroup of pediatric patients.
Objectives:
To investigate the control status of bronchial asthma (referred to as "asthma") in school-age children with normal pulmonary ventilation function and the occurrence of acute attacks within 1 year of follow-up.
Methods:
A retrospective analysis was conducted on clinical data of 327 children aged 6-14 years with bronchial asthma and normal pulmonary ventilation function from April to September 2021. Based on the measured value of one second rate (FEV1/FVC), the children were divided into the ≥80% group (267 cases) and the <80% group (60 cases). The pulmonary ventilation function, asthma control level, and occurrence of acute attacks within 1 year were compared between the two groups.
Results:
The baseline pulmonary ventilation function in the <80% group was lower than that in the ≥80% group, and the proportion of small airway dysfunction was higher than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the small airway function indices in the <80% group improved but remained lower than those in the ≥80% group (P<0.05). The rate of incomplete asthma control at baseline was 34.6% (113/327), and the asthma control level in the <80% group was lower than that in the ≥80% group (P<0.05). After standardized treatment for 1 year, the asthma control level in the <80% group remained lower than that in the ≥80% group, and the proportion of acute asthma attacks was higher than that in the ≥80% group (P<0.05).
Conclusions:
Approximately one-third of school-age children with asthma still have incomplete asthma control when their pulmonary ventilation function is normal. Among them, children with measured FEV1/FVC<80% have an increased risk of acute asthma attacks and require close follow-up and strengthened asthma management.
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