Evaluation of spirometry in asthmatic children

Abstract

Background:The use of spirometry in the assessment of children with asthma is taking on new importance with the realization that considerable airway obstruction may exist in the absence of clinically detectable abnormalities. Hence this study was planned to evaluate, forced expired volume in 1 second (FEV1), forced vital capacity (FVC), the forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) and Peak Expiratory Flow rates (PEFR) in asthmatic children aged 6-12 years. The objective of the study was to determine prevalence of asthma according to clinical classification and identify common trigger factors and to determine which is more sensitive between FEV1, FVC, FEV1/FVC, FEF 25-75 and PEFR in different age groups.Methods: The present study was conducted among 60 patients of age group 6 to 12 years with asthma. Forced vital capacity (FVC), Forced expiratory volume in 1 second (FEV1), Ratio of forced expiratory volume in 1 second and forced vital capacity (FEV1/FVC), PEFR and Forced expiratory flow between 25-75% were recorded. Data was analyzed using chi-square test, Karl Pearson’s correlation coefficient. Level of significance was set at 5%. All p values less than 0.05 were treated as significant.Results:In Age and Sex wise correlation with classification of asthma, a male preponderance was seen in all the age groups i.e. between 6-8 years, 9-10 years and 11-12 years. Mosquito coils were the most common indoor agents to trigger an asthmatic accounting for nearly 80%. Amongst the outdoor triggers, exacerbation of symptoms during the cold weather accounted for 90 % followed by variation during festivals like Diwali, dust, pollution, exercise and insects. Comparison of Pre and Post bronchodilator FEF 25-75 values have shown a high statistical significance.Conclusions:Parents need to be educated regarding certain modifiable factors that can improve the prognosis. Pulmonary Function tests should be performed as a routine office procedure. Peak expiratory flow meter is a handy instrument. In all children above 6 years of age suspected to have asthma, this test should be performed before beginning therapy.