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Pulmonary Medicine
Volume 2012, Article ID 724139, 8 pages
Clinical Study

Pulmonary Function Tests in Emergency Department Pediatric Patients with Acute Wheezing/Asthma Exacerbation

1Department of Emergency Medicine, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
2Nemours Research Lung Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
3Department of Respiratory Care, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA
4Department of Pediatrics, Jefferson Medical College, Philadelphia, PA 19107, USA
5Departments of Physiology and Pediatrics, Temple University School of Medicine, Philadelphia, PA 19140, USA

Received 19 September 2012; Revised 23 October 2012; Accepted 23 October 2012

Academic Editor: N. Ambrosino

Copyright © 2012 Kathryn Giordano et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Pulmonary function tests (PFT) have been developed to analyze tidal breathing in patients who are minimally cooperative due to age and respiratory status. This study used tidal breathing tests in the ED to measure asthma severity. Design/Method. A prospective pilot study in pediatric patients (3 to 18 yrs) with asthma/wheezing was conducted in an ED setting using respiratory inductance plethysmography and pneumotachography. The main outcome measures were testing feasibility, compliance, and predictive value for admission versus discharge. Results. Forty patients were studied, of which, 14 (35%) were admitted. Fifty-five percent of the patients were classified as a mild-intermittent asthmatic, 30% were mild-persistent asthmatics, 12.5% were moderate-persistent asthmatics, and 2.5% were severe-persistent. Heart rate was higher in admitted patients as was labored breathing index, phase angle, and asthma score. Conclusions. Tidal breathing tests provide feasible, objective assessment of patient status in the enrolled age group and may assist in the evaluation of acute asthma exacerbation in the ED. Our results demonstrate that PFT measurements, in addition to asthma scores, may be useful in indicating the severity of wheezing/asthma and the need for admission.