Russell J Hopp1, Muhammad A Pasha2. 1. a Department of Pediatrics , Creighton University , Omaha , NE , USA , and. 2. b Department of Medicine , Albany Medical Center , Albany , NY , USA.
Abstract
INTRODUCTION: A well-performed spirometry, using a change in forced expiratory volume in one second (FEV(1)) after albuterol, is commonly used to support the likelihood of an asthma diagnosis. The current standard, accepted by the 2007 National Heart Lung and Blood Institute Asthma Expert Panel Report-3 (EPR-3) guidelines, is a 12% improvement in the FEV(1) after a bronchodilator. OBJECTIVE: We sought to determine whether existing studies support or refute using a 12% improvement as a significant change in FEV(1) in children and adolescents. DATA SOURCES: We reviewed the literature of children and adolescents using Medline searches to discover pertinent population studies and comparative studies that included FEV(1) measurements. RESULT: The majority of the discovered studies suggest a less stringent improvement in FEV(1) in children might be applicable. CONCLUSION: Supported by the published literature, we suggest an alternative interpretive strategy of expressing the results of a spirometry measurement when a diagnosis of asthma in a child is being considered using a bronchodilator response.
INTRODUCTION: A well-performed spirometry, using a change in forced expiratory volume in one second (FEV(1)) after albuterol, is commonly used to support the likelihood of an asthma diagnosis. The current standard, accepted by the 2007 National Heart Lung and Blood Institute Asthma Expert Panel Report-3 (EPR-3) guidelines, is a 12% improvement in the FEV(1) after a bronchodilator. OBJECTIVE: We sought to determine whether existing studies support or refute using a 12% improvement as a significant change in FEV(1) in children and adolescents. DATA SOURCES: We reviewed the literature of children and adolescents using Medline searches to discover pertinent population studies and comparative studies that included FEV(1) measurements. RESULT: The majority of the discovered studies suggest a less stringent improvement in FEV(1) in children might be applicable. CONCLUSION: Supported by the published literature, we suggest an alternative interpretive strategy of expressing the results of a spirometry measurement when a diagnosis of asthma in a child is being considered using a bronchodilator response.
Authors: Amy Chan; Anna De Simoni; Vari Wileman; Lois Holliday; Chris J Newby; Claudia Chisari; Sana Ali; Natalee Zhu; Prathima Padakanti; Vasita Pinprachanan; Victoria Ting; Chris J Griffiths Journal: Cochrane Database Syst Rev Date: 2022-06-13