Allergy is a specific response of the immune system to certain external factors. In the course of this response, various accompanying symptoms can be encountered, including allergic rhinitis, which is the most common manifestation of this condition. In terms of chronicity, it is likely that children suffering from this condition are at risk of developing bronchial asthma. It is therefore very important to monitor the performance of the respiratory system by means of spirometry, a test that shows the ventilation performance of the respiratory system.
Allergy, i.e. an excessive, specific response of the immune system to external factors that causes symptoms, is a common cause of chronic nasal obstruction, which is a frequent and important ENT problem, especially in children. The epidemiology of this ailment, shows an increase in the population affected, which is linked to increased exposure to allergens, particularly in the home environment. We are talking about contact with allergens such as house dust mites, moulds, animal hair, as well as toxic substances, for example from tobacco smoke. Lifestyle, including diet and hygiene, is also important.
AR or Allergic Rhinitis
One of the most common allergen-induced conditions today is allergic rhinitis (AR), which is an inflammatory process that develops on the nasal mucosa. The main symptoms include the leakage of serous or mucous nasal secretions. There are also cases where patency is impaired, an itching sensation as well as sneezing. Characteristics of allergic rhinitis include the recurrence of symptoms and the fact that they resolve spontaneously or with treatment.
A diagnosis of AR is important in the context of asthma, as it is a risk factor for its development. Among people diagnosed with AR, an ongoing inflammatory process in the bronchi that is asymptomatic can be observed. [1]
What is spirometry?
Spirometry is a functional test of the respiratory system and is classified as a basic test because it determines the functional and flow values that characterise the functioning of the respiratory system. In other words, spirometry is designed to check ventilatory efficiency. In many cases, it provides a diagnostic basis for determining the disease entity, as well as being a tool that allows the control and evaluation of the treatment process. Many times, on the basis of the spirometric examination, the patient's further prognosis is determined. This examination is carried out using a special device, called a spirometer, which displays the results tested on graphs indicating the volume at a given time and the flow at a given volume.
Tested: processes
The respiratory system, by performing its functions properly, ensures adequate oxygenation of the blood in our body and removes carbon dioxide. Thanks to ventilation, the composition of gases in the alveoli remains constant and, as a result of alveolar perfusion, the alveoli are "washed" by oxygenated blood, where gas exchange takes place by means of diffusion. The above-mentioned processes, are determinants of the efficiency of the respiratory system.
As a result of the spirometric examination, we obtain a picture of the functioning of the ventilation efficiency, i.e. one of the three basic processes on which the proper functioning of the lungs and respiratory system depends.
Indications and contraindications for spirometry
Assessment of respiratory function is indicated in people with any disease symptoms indicating respiratory dysfunction. Also important in this respect are people in risk groups for these conditions, i.e. smokers, people living in smoky environments, in whom spirometry should be performed as a preventive measure. In addition, people already suffering from pulmonary diseases should undergo this test to monitor the progression of the disease.
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It is worth mentioning, however, that people may experience a significant increase in chest pressure, such as those with an aortic aneurysm or increased intracranial pressure. In such cases it is too dangerous to perform spirometry. [2]
Spirometry vs AR
As the specialist literature indicates, by definition, a spirometric test can be performed in a five-year-old child. Why the age restriction? Referring to the findings of repeated examinations by specialist physicians, there is a significant group of children who are unable to perform the test properly, as it basically involves a full, forceful exhalation several times, each time preceded by a deep and forceful inhalation.
Nevertheless, as shown by studies and conclusions from clinical practice, the indices obtained from spirometry make it possible to determine whether a child with AR is at risk of developing bronchial asthma. In fact, there is a parameter - FEV, which defines the first-second expiratory volume, and which is considered to be the best, i.e. the most authoritative parameter, determining bronchial patency
in paediatric patients.
Hence, it is important to perform spirometry as a follow-up test in children who are struggling with AR
It is also worth noting that this phenomenon has been studied, on the basis of spirometric measurements in children with AR and asthma, as well as in healthy children who were the control group. The FEV index, in the group of children with AR and asthma, was reduced. Thus, conclusions can be drawn about the need to perform spirometry in children with AR, in order to control the development of the disease and the possible development of asthma. [1]
From the point of view of the recommendations of the Polish Phtysiatry and Pneumonology Association, spirometry is an objective way of estimating how the condition progresses and how it affects respiratory function. This is an important recommendation, especially in the context of monitoring the emergence of possible respiratory dysfunction. [3]
