Spirometry In Classification and Management of Childhood Asthma

Abstract

Asthma is the most common chronic illness of childhood. Measurement of lung function provides a better view in diagnosis and management of asthma. Considering scarcity of literature and usefulness of spirometry, this study done to assess role of spirometry on childhood asthma. Prospective study was conducted on children (n=52, age 6 to 12 years) attending asthma clinic in P.D.U. Medical College and Civil Hospital, Rajkot over a period of 2 years (oct-2016 to sep-2018). Diagnosis and management of asthma was done clinically and by spirometry according to GINA – 2015 guidelines. Spirometry is done for minimum 3 times with gap of 3 month each. High positive correlation between clinical and spirometry diagnosis with milder form of asthma. While severe form of asthma is more likely to under diagnosed and under treated (Intermittent, mild persistent and moderate persistent asthma positive correlation 71.5%, 77.3% and 32% respectively). Improvement in FEV1 and FEF25-75 values observes on subsequent spirometry ((FEV1)1 to (FEV1)2 p value=0.000, (FEV1)1 to (FEV1)3 p value=0.001, (FEF25-75)1 to (FEF25-75)2 p value=0.000, (FEF25-75)1 to (FEF25-75)3 p value=0.00). Significant decrease in amount of drug (inhalation steroid – budesonide, mcg/day) required (spirometry-1 mean 357.69, spirometry-2 mean 350.00, spirommetry-3 mean 273.07, p value=0.009). Spirometry is to be done in all children at the time of initial diagnosis of asthma and then once or twice every year. FEV1 and FEF25-75 is important tool for monitoring and assessing treatment response in asthma. Spirometry based treatment implementation leads to better asthma control, optimum dose adjustment.