2005 OPEN FORUM Abstracts
THE ROLE OF SPIROMETRY IN ASTHMA MANAGEMENT IN VIETNAMLE THI TUYET LAN MD PhD
University Medical Center At Hochiminh City Vietnam 215 Hongbang District 5 Hochiminh City Vietnam
Introduction: GINA underlines the role of pulmonary function test in asthma especially spirometry. In order to assess the role of spirometry in asthma management, we have performed 1646 spirometric tests on asthmatic patients.
Materials: 1646 asthma patients were diagnosed and treated at the asthma outpatient management unit of the University Medical Center at HoChiMinh city from June 2001 to April 2004.
The spirometric test and bronchodilator test were adhered to the methods of ATS and were performed for all the patients at the first time. The diagnosis of asthma was made following the criteria of GINA.
A second spirometric test was performed 2 weeks later and repeated every 1 to 3 months
Results and discussion: There were 9% of asthmatic patients who did not respond to the bronchodilator test in the first visit.There were also 4% of asthmatic patients with normal spirogram at the time of examination but with positive bronchodilator test.
Although most of patients have had typical spirogram and symptoms of asthma (76,8%) only 44,8% of asthmatic patients were previously correctly diagnosed. The rest (23,2%) have had non-typical asthma which had been difficult to make diagnosis without spirometry. They composed of dyspnea- variant of asthma (7,8%), cough -variant of asthma (6,9%), chest tightness variant of asthma (0,7%) and COPD-like asthma (7,8%).
The big-boy asthmatic patients have had normal spirogram but with positive bronchodilator test. The objective assessment and following up were based on series of spirometric tests. The differential diagnosis from upper airway obstruction was clearly made from the shape of the flow-volume curve.
The staging of asthma severity would had been lower if the peak expiratory flow value had not been considered.
Conclusion: The use of spirometric test is extremely helpful in asthma management. The under-diagnosis and under-treatment of asthma would be limited if the spirometer is used more widely. A network of asthma management units equipped with spirometers in Vietnam is gradually formed.