The importance of spirometry in the assessment of childhood asthma
M. R. Bye, D. Kerstein and E. Barsh
Department of Pediatrics, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461.
OBJECTIVE--To assess the pulmonary function of children with asthma at the
time of a routine follow-up visit when they were judged to be clinically
well. DESIGN--Pulmonary function tests were performed on children with a
previous diagnosis of asthma. None had had any symptoms for at least 6
weeks. All had normal Wright peak flow rates and normal findings at
physical examination. SETTING--General pediatric and pediatric pulmonary
clinic at a municipal hospital in the Bronx, NY. PATIENTS--Sixty-five
children with asthma who fit the above criteria. All were able to perform
spirometry adequately. Their mean (+/- SD) age was 11 +/- 3 years, and
their median age was 10 years. SELECTION PROCEDURES--All clinic patients
were screened as possible participants. The 65 patients were deemed
eligible, and were willing and able to perform spirometry.
INTERVENTIONS--None. MEASUREMENTS AND RESULTS--The group's mean (+/- SD)
forced expiratory volume in 1 second/forced vital capacity ratio was 80%
+/- 8%, and their mean mid-maximal expiratory flow was 66% +/- 23% of the
predicted value. Of the 65 patients, 11 (17%) had forced expiratory volume
in 1 second/forced vital capacity ratios of less than 72%, and 35 (54%) had
a mid-maximal expiratory flow of less than 65% of the predicted value.
CONCLUSION--Failure to perform spirometry in children with asthma results
in underdiagnosis of airflow obstruction. This may result in obstruction
persisting into adulthood and/or progression to hyperinflation.
