Spirometry for the primary care pediatrician.

Abstract

1. Robert Kaslovsky, MD* 2. Matthew Sadof, MD† 1. *Department of Pediatrics, Albany Medical College, Albany, NY 2. †Department of Pediatrics, Tufts University School of Medicine, Baystate Medical Center, Springfield, MA * Abbreviations: FEF25%–75%: : forced expiratory volume between 25% and 75% of vital capacity FET: : forced expiratory time FEV1: : forced expiratory volume in 1 second FVC: : forced vital capacity NHLBI: : National Heart, Lung, and Blood Institute The 2007 National Heart, Lung and Blood Institute expert panel asthma guidelines recommend that spirometry be part of routine asthma diagnosis and monitoring of therapy, yet only 35% of pediatric practices use spirometry for patients with asthma. Pediatricians should be aware that routine office spirometry is feasible, practical, and important for optimizing care for children with respiratory symptoms or risk of lung disease. After completing this article, readers should be able to: 1. Understand the use of spirometry to diagnose and monitor the treatment of asthma. 2. Identify the details needed for the optimal performance and interpretation of spirometry. Spirometry is a useful tool to help the practitioner distinguish normal from abnormal pulmonary function, delineate obstructive from restrictive defects, and monitor the disease or treatment. Most hospitals and many specialty offices (eg, pulmonology and allergy) have ready access to and familiarity with spirometry. The pediatric primary care practice may not have a spirometer or may lack experienced personnel to properly administer and/or interpret the test results. A published survey with data from 360 primary care practices revealed that only 52% used spirometry for patients with a diagnosis of asthma, and of those, only 35% of pediatric practices (vs 75% of family medicine practices) used spirometry in clinical practice. (1) Equipment for spirometry is readily available at a reasonable cost, and the procedure and interpretation of results are billable services that can be used by any primary care practice. The interpretation of results can be performed by the primary care physician, possibly with the help of a specialist. ### Who? Most children older than …