Pediatric Reactive Airway Disease Guidelines

Updated: Jul 16, 2021
  • Author: Eric S Chin, MD; Chief Editor: Kirsten A Bechtel, 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 2021 by the European Respiratory Society (ERS) in European Respiratory Journal. [29] Recommendations include the following:

  • The European Respiratory Society (ERS) recommends spirometry as first-line diagnosis in children aged 5-16 years with suspected asthma.
  • ERS recommends bronchodilator reversibility testing as first-line diagnosis in all children with FEV1 < LLN or < 80% predicted and/or FEV1/FVC < LLN or < 80% predicted.
  • ERS recommends FeNO as first-line diagnosis in children aged 5-16 years with suspected asthma.
  • ERS recommends against PEFR variability testing as the primary objective test on its own to diagnose asthma in children aged 5-16 years.
  • ERS recommends against diagnosing asthma in children aged 5-16 years based on clinical history alone or following a single abnormal objective test.
  • ERS recommends against using an improvement in symptoms after a trial of preventive medication alone to diagnose asthma in children aged 5-16 years.
  • ERS recommends against using skin prick tests as diagnostic tests for asthma in children aged 5-16 years.
  • ERS recommends a direct bronchial challenge test using methacholine in children aged 5-16 years with suspected asthma where asthma diagnosis could not be confirmed with first-line tests.
  • ERS recommends an indirect bronchial challenge test using a treadmill or a bicycle in children aged 5-16 years with suspected asthma with exercise-related symptoms where asthma diagnosis could not be confirmed with first-line tests.