Recommended Frequency of Spirometry Measurement

For children, lung function increases as they grow older until maximal lung function is achieved, generally at 20 years of age. Children with uncontrolled asthma may experience a reduction in lung growth. The postbronchodilator FEV₁ measure provides important information about lung growth patterns over time so that asthma control can be assessed longitudinally.

The Expert Panel recommends the following frequencies for spirometry measurements:

1. At the time of initial assessment (Evidence C)
2. After treatment is initiated and symptoms and peak expiratory flow (PEF) have stabilized, to document attainment of (near) “normal” airway function
3. During a period of progressive or prolonged loss of asthma control
4. At least every 1 to 2 years to assess the maintenance of airway function (Evidence B, extrapolation from clinical trials)

Spirometry may be indicated more often than every 1 to 2 years, depending on the clinical severity and response to management (Evidence D). These spirometry measures should be followed over the patient’s lifetime to detect potential for decline and rate of decline of pulmonary function over time (Evidence C).

Primary care practitioners should consider referral to an asthma specialist for children with labile asthma who require repeated assessments of lung function to document sustained asthma control.

Categories of evidence are as follows: B, randomized controlled trials; C, nonrandomized trials and observational studies; and D, panel consensus judgment. Further information about the evidence categories is given on page 7 of the Expert Panel Report.

^{The National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma: Full Report 2007. Bethesda, MD: NHLBI; 2007:282. http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf. Accessed July 1, 2016}