A clinical study of hyperreactive airway disease with wheeze in children aged five to twelve years with special reference to pulmonary function test


  • Arjun Reddy Department of Pediatrics, Navodaya Medical College, Raichur, Karnataka, India
  • Abhishek Patel Department of Pediatrics, Navodaya Medical College, Raichur, Karnataka, India
  • Sanjeev Chetty Department of Pediatrics, Navodaya Medical College, Raichur, Karnataka, India




Bronchodilator, HRAD, PFT, Spirometry


Background: Pulmonary function test is the easiest and most cost-effective method to evaluate respiratory functions. PFT can be measured by a simple instrument spirometer. Measuring PFT has been suggested as an important tool in understanding HRAD and its complications and management by all international guidelines.  The objectives of this study were to clinically diagnose the hyperreactive airway disease in children coming to Navodaya Medical College, Raichur, of age group 5 to 12 years. And to perform pulmonary function test before and after the use of a bronchodilator.

Methods: PFT was measured in 100 children who came with HRAD with wheeze using Spiro lab III spirometer. The child was given then nebulization with salbutamol and PFT was performed again after 30 min.

Results: A total of 100 clinically diagnosed cases of HRAD of age group 5 to 12 years of both the gender was taken into the study, of which more than 44% of the children showed more than 20% improvement in parameters FEV1, PEF, FVC and marginal improvement in EV1/FVC post bronchodilator compared to their prebronchodilator parameters. The young children of both the gender showed better improvement than elder children.

Conclusions: Spirometry is the best tool to assess HRAD even in younger children, early diagnosis and regular follow up with PFT helps to understand and prevent the progression of the disease with prompt treatment.                     


National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: national heart lung and blood Institute. 2007. (NIH publication no.08-4051). Available at: www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm.

Kleigman RM, Jenson HB, Behrman RE, Stanton BF, eds. Regulation of respiration In: Nelson textbook of Pediatrics. 18th ed. India: Elsevier. 2007;(2):1728-1730.

Pal GK, Pal P. Pulmonary function tests. In: Textbook of practical physiology, 1st ed. Chennai: Orient Longman Ltd.; 2001:178-190.

Hughes JMB, Pride NB. Lung function tests. Principles and clinical applications. In: Pride NB, Texts of forced expiration and inspiration, 1st ed. W.B. Saunders Publishers; 1999:23-25.

Al-Dawood K. Peak expiratory flow rate in Saudi school boys at Al-Khobar City, Saudi Arabia. Saudi Med J. 2000;21(6):561-4.

Swaminathan S, Venkatesan P, Mukunthan R. Peack expiratory flow rate in South Indian Children. Indian Pediatr. 1993;30(2):207-11.

Ganong WF. Regulation of respiration: In: Review of medical physiology. 22nd ed. India, Mc Graw Hill: Company; 2005:671-680.

Seaton A, Seaton D, Leiteh GA. Epidemiology and respiratory diseases, In: Crofon and Douglas respiratory diseases, 4th ed. UK: Blackwell Science Oxford; 1989:90.

Guyton Ac, Hau JE. Pulmonary ventilation. In: Textbook of medical physiology, 11th Ed. India: W.B. Saunders Company; 2006:471-482.

Gardner RM. Standardization of spirometry: 1987 update. Official statement of the American thoracic Society. Am Rev Respir Dis. 1987;136:1285-98.

Srivastava A, Kapoor RK, Misra PK, Srivastava KL, Thakur S, Shukla N. Pulmonary function tests in normal Indian children and changes in respiratory disorders. Indian Pediatr. 1995;32(6):629-34.

Budhiraja S, Singh D, Pooni PA, Dhooria GS. Pulmonary functions in normal school children in the age group of 6-15 years in north India. Iranian J Pediat. 2010;20(1):82.

Bhattad SS, Asudani B, Dandge VP. Comparison of pulmonary function tests in asthmatic and normal children. Int J Recent Trends Sci Technol. 2013;5(3):170-3.

Bacharier LB, Strunk RC, Mauger D, White D, Lemanske Jr RF, Sorkness CA. Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function. Am J Resp Critic Care Med. 2004;170(4):426-32.

Paull K, Covar R, Jain N, Gelfand EW, Spahn JD. Do NHLBI lung function criteria apply to children? A cross‐sectional evaluation of childhood asthma at National Jewish Medical and Research Center, 1999–2002. Pediatr Pulmonol. 2005;39(4):311-7.

David P. Johns PhD, Rob Pierce MD, Predicted normal values. In: Guide to spirometry 2nd ed. Australia. McGraw-Hill; 2008:4-10.

Bussamra MH, Cukier A, Stelmach R, Rodrigues JC. Evaluation of the magnitude of the bronchodilator response in children and adolescents with asthma. Chest. 2005;127(2):530-5.

Ghalibafsabbaghi B, Raj D, Lodha R, Kabra SK. Assessment of bronchodilator response in preschool children by pulmonary function tests. Indian Pediatr. 2013;50(10):957-60.

Beydon N, Pin I, Matran R, Chaussain M, Boulé M, Alain B, et al. Pulmonary function tests in preschool children with asthma. Am J Resp Critic Care Med. 2003;168(6):640-4.






Original Research Articles