Evaluation of spirometry in asthmatic children
DOI:
https://doi.org/10.18203/2349-3291.ijcp20171071Keywords:
Asthma, Pulmonary function test, SpirometryAbstract
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.
Metrics
References
Banasiak NC. Spirometry in primary care for children with asthma pediatr nurs. 2014;40(4):195-8.
Rabe KF. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American journal of respiratory and critical care medicine. 2007;176(6):532-55.
Kumar, V, Abbas AK, Fausto N, Aster J. Robbins and Cotran pathologic basis of disease (8th ed.). Saunders; 2010:688.
Martinez FD. Genes, environments, development and asthma: reappraisal. European Respiratory Journal. 2007;29(1):179-84.
Madan D, Singal P, Kaur H. Spirometric Evaluation of Pulmonary Function Tests in Bronchial Asthma Patients. Journal of Exercise Science and Physiotherapy. 2010;6(2):106-11.
McCormack MC, Paul LE. Making the Diagnosis of Asthma Respiratory care. 2008;53(5):583-92.
Paramesh H. Epidemiology of asthma in India. Indian J Pediatr. 2002;69(4):309-12.
Yao TC, Ou LS, Yeh KW, Lee WI, Chen LC, Huang JL. Associations of age, gender, and BMI with prevalence of allergic diseases in children: PATCH Study Group J Asthma. 2011;48(5):503-10.
Tsai CL, Lee WY, Hanania NA, Camargo CA. Age-related differences in clinical outcomes for acute asthma in the United States, 2006-2008. Journal of Allergy and Clinical Immunology. 2012 May 31;129(5):1252-8.
Centers for disease control and prevention. Adult self-reported current asthma revalence rate by sex and state or territory: BRFSS; 2008.
Garba BI, Ballot DE, White DA. Home circumstances and asthma control in Johannesburg children. Current Allergy & Clinical Immunology. 2014;27(3).
Strachan D, Warner J, Pickup J, Schweigher M, Pennington H, Jones M et al. Are we too clean? Health and Hygiene Supplement. 2003;3:1-12.
Petronella SA, Conboy-Ellis K. Asthma Epidemiology: risk factors, case finding, and the role of asthma coalitions. Nurse Clin North Am. 2003;38(4):725-35.
Azizi BHO, Zulkifli HI, KasimIndoor MS. Air Pollution and Asthma in Hospitalized Children in a Tropical Environment. Journal of Asthma. 1995;32(6):413-8.
Zhang L, Jiang Z, Tong J, Wang Z, Han Z, Zhang J. Using charcoal as base material reduces mosquito coil emissions of toxins. Indoor air. 2010;20(2):176-84.
Liu W, Zhang J, Hashim JH, et al. Mosquito coil emissions and health implications. Environ Health Perspect. 2003;111:1454-60.
Chen Y, Sheng G, Bi X. Emission factors for carbonaceous particles and polycyclic aromatic hydrocarbons from residential coal combustion in China. Environ SciTechnol. 2005;39:1861-7.
Pauluhn J. Mosquito coil smoke inhalation toxicity. Part I: validation of test approach and acute inhalation toxicity. J ApplToxicol. 2006;26:269-78.
Anandi S, Tullu MS, Lahiri K. Evaluation of symptoms & spirometry in children treated for asthma. Indian J Med Res. 2016;144:124-7.
Sposato B, Scalese M, Migliorini MG, Di Tomassi M, Scala R. Small Airway Impairment and Bronchial Hyperresponsiveness in Asthma Onset. Allergy, Asthma and Immunology Research. 2014;6(3):242-51.
Jat KR. Spirometry in children. Primary Care Respiratory Journal. 2013;22:221–229.
Jalees F, Gupta N, Karoli R, Shukla V, Siddiqui Z, Gupta N. Ventilatory functions in diabetes mellitus- an assessment made by spirometry and six minute walk test. International Journal of Contemporary Medical Research. 2016;3(12):3549-51.
Garg N, Verma P, Jain N. Comparative study of pulmonary and anthropometric parameters in females of garhwal. International Journal of Contemporary Medical Research. 2016;3(7):1873-7.