Sixty-four pediatric patients
with asthma exacerbation were studied. The children
were subjected to respiratory resistance evaluation using the Airflow
Perturbation Device (APD) and spirometry evaluation. They were then administered albuterol and 15 minutes later the APD and
spirometry evaluations were repeated. Eleven of the children could not
perform spirometry. The APD results
demonstrated that respiratory resistance of the patients decreased by about
20%, indicating that the APD could detect the expected response to
bronchodilator. However, no similar conclusion could be made with the
spirometry parameters (FVC, FEV1, FEV1/FVC, and FEF25% -
75%) performed on the same patients. The differences on the spirometry
parameters did not change significantly
before and after bronchodilator administration. Furthermore, these
differences were negligibly increased or decreased for some with no consistency
between the FVC, FEV1, FEV1/FVC, and FEF25% - 75%. Even though all the children
were clinically improved after albuterol administration and discharged home,
this could not be demonstrated by spirometry data. This study validates
previous reports that spirometry is not a reliable pulmonary diagnostic tool
for young children, as spirometry is highly effort-dependent and requires a
substantial degree of patient cooperation. APD on the other hand is a reliable,
simple, effortless diagnostic tool that can be utilized in evaluation and
management of children with asthma symptoms and exacerbation.
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