Pediatric Asthma Guidelines

Updated: Dec 20, 2021
  • Author: Girish D Sharma, MD, FCCP, FAAP; Chief Editor: Kenan Haver, MD  more...
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Guidelines

Guidelines Summary

European Respiratory Society

Guidelines for the diagnosis of asthma in children aged 5–16 years were published in November 2021 by the European Respiratory Society (ERS) in European Respiratory Journal. [70]  Recommendations include the following:

  • Spirometry is recommended as part of the diagnostic workup of children aged 5–16 years with suspected asthma.
  • Bronchodilator reversibility (BDR) testing is recommended in all children with FEV 1< LLN or < 80% pred and/or FEV1/FVC < LLN or < 80%.
  • Measurement of exhaled nitric oxide ( F eNO) is recommended as part of the diagnostic workup of children aged 5–16 years with suspected asthma.
  • Diagnosing asthma in children based on clinical history alone or following a single abnormal objective test is not recommended.
  • PEFR variability testing as the primary objective test on its own to diagnose asthma in children aged 5–16 years is not recommended.
  • A direct bronchial challenge test using methacholine is recommended in children aged 5–16 years under investigation for asthma where asthma diagnosis could not be confirmed with first-line objective tests.