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The Importance of Spirometry in the Assessment of Childhood Asthma

Michael R. Bye, MD; Diane Kerstein, MD; Elliot Barsh, MD
Am J Dis Child. 1992;146(8):977-978. doi:10.1001/archpedi.1992.02160200099037.
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•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.(AJDC. 1992;146:977-978)

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