Functional Lung Examination in Diagnostics of Asthma and Its Phenotypes

Abstract

In this chapter, we review the diagnostic approach to asthma phenotypes in children using lung function testing. Various methods are reviewed and their advantages and disadvantages are discussed. Medical history and physical examination including lung auscultation is the first line examination, which may raise the suspicion on asthma. Besides the simple lung auscultation, more advanced approaches (computer analysis of breath sounds) are described. Spirometry and other classical lung function testing methods (body plethysmography, dilution techniques) are discussed with respect to their contribution to asthma diagnostics and phenotype classification. Afterward, impulse oscillometry and methods intended for patients with insufficient cooperation follows. We highlight their potential in diagnostics of early asthma stages. Measurement of exhaled nitric oxide is discussed and its potential for allergic asthma (eosinophilic inflammation) detection is assessed. In conclusion, various lung function testing methods may contribute to both setting the diagnosis of asthma itself and classification of asthma phenotypes. Their smart combination allows for more precise diagnostics and treatment of young patient with bronchial asthma.