<h3 style="text-align:center;">Learn More About These Available Noninvasive Techniques for Assessment of Lung Function3-5</h3>

<h3 style="text-align:center;">Global Lung Function Initiative (GLI) Suggests Using Z-Scores to Standardize FEV1 Measurements and Minimize Confounding Variables9,10</h3>

<h3>Peak expiratory flow monitoring with a respiratory diary may also sometimes be useful for continued assessment of lung function and earlier detection of future exacerbations outside of a physician’s office2</h3>

References: 
 CoV, coefficient of variation; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; GLI, Global Lung Function Initiative; HSE, Health Survey for England; NHANES, National Health and Nutritional Examination Survey; SAPALDIA, Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults.

 Spirometry

<h4>Abnormalities in IOS components (compared to reference values) are more prevalent in individuals with more severe disease according to GINA guidelines and can be used to identify inadequate asthma control in pediatric patients with normal spirometry13,14</h4>

References: 
 AX, area of reactance; GINA, Global Initiative for Asthma; IOS, impulse oscillometry; R5-R20, peripheral airway resistance; X5, reactance at 5Hz.

Oscillometry

References: 
 ERV, expiratory reserve volume; FRC, functional residual capacity; FVC, forced vital capacity; IC, inspiratory capacity; IRV, inspiratory reserve volume; RV, residual volume; SVC, slow vital capacity; TLC, total lung capacity; Vt, volume-time.

Body Plethysmography

ASTHMA

1. Fuhlbrigge AL, et al. Pediatrics. 2006;118(2):e347-e355.&nbsp; 
 2. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated May 2025. Accessed May 30, 2025. https://ginasthma.org/2025-gina-strategy-report/&nbsp; 
 3. Merck Manual Professional Version. Airflow, lung volumes, and flow-volume loop. Accessed January 23, 2024. https:// www.merckmanuals.com/professional/pulmonary-disorders/tests-of-pulmonary-function-pft/airflow, lung-volumes,-and-flow-volume-loop&nbsp; 
 4. Galant SP, et al. Ann Allergy Asthma Immunol. 2017;118(6):664-671.&nbsp; 
 5. Criée CP, et al. Respir Med. 2011;105(7):959-971.&nbsp; 
 6. Tseng HJ, et al. Radiographics. 2017;37(4):1037-1058.&nbsp; 
 7. Haynes JM. Respir Care. 2015;60(5):e105-e109.&nbsp; 
 8. Bui DS, et al. Ann Am Thorac Soc. 2020;17(3):302-312.&nbsp; 
 9. Stanojevic S, et al. Eur Respir J. 2022;60(1):2101499.&nbsp; 
 10.Quanjer PH, et al. Eur Respir J. 2012;40(6):1324-1343.&nbsp; 
 11.Hopp RJ, et al. Clin Rev Allergy Immunol. 2022;62(1):145-159.&nbsp; 
 12.Porojan-Suppini N, et al. Ther Clin Risk Manag. 2020;16:1139-1150.&nbsp; 
 13.Postma DS, et al. Lancet Respir Med. 2019;7(5):402-416.&nbsp; 
 14.Skylogianni E, et al. Paediatr Respir Rev. 2016;18:46-51.&nbsp; 
 15.Jerzyńska J, et al. Ann Allergy Asthma Immunol. 2015;115(4):272-276

Assessing Pediatric Lung Function

References :&nbsp; 
 Guidelines for the management of asthma are not intended to impose a standard of care. 
 They provide the basis for rational decisions in the management of asthma.

FeNO, fractional exhaled nitric oxide.

GINA Emphasizes

ICS, inhaled corticosteroid; LABA, long-acting beta agonist; MART, maintenance and reliever therapy (ICS-formoterol as both maintenance and reliever); SABA, short-acting beta agonist.

GINA Suggests

GINA Recommends

ACQ, asthma control questionnaire; AQLQ, asthma quality of life questionnaire; c-ACT, childhood asthma control test; EOS, eosinophils; FeNO, fractional exhaled nitric oxide; IgE, immunoglobulin E.

GINA-Recommended Approach

RESPIRATORY

1. McGeachie MJ, et al. N Engl J Med. 2016;374:1842-1852. 
 2. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated 2024. Accessed June 6, 2024. <a href="https://ginasthma.org/reports/">https://ginasthma.org/reports/</a> 
 3. Fuchs O, et al. Lancet Respir Med. 2017;5(3):224-234. 
 4. Lanz MJ, et al. Pediatr Pulmonol. 2019;54(3):348-357. 
 5. Pike KC, et al. Arch Dis Child. 2018;103(4):392-397.

Pediatric Management

*If clinically visible, the achievement of histological remission before proceeding to esophageal dilatation is advisable. †Assessment of poor esophageal distensibility by means of esophageal panometry before dilatation is advisable.
ABBREVIATIONS: b.i.d., twice a day; BOT, budesonide orally disintegrating tablet; FFED, four-food elimination diet; GERD, gastroesophageal reflux disease; PPIs, proton pump inhibitors; OFED, one-food elimination diet; SFED, six-food elimination diet; TFED, two-food elimination diet; Th2, T-helper cell type 2.
REFERENCE: <a href="https://www.sciencedirect.com/science/article/pii/S1590865824003013?via%3Dihub" target="_blank">de Bortoli N, Visaggi P, and Penagini R, et al. The 1st EoETALY Consensus on the Diagnosis and Management of Eosinophilic Esophagitis-Current Treatment and Monitoring. Dig Liver Dis. 2024;56(7):1173-1184.</a>

EOSINOPHILIC-ESOPHAGITIS-EOE

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EoETaly Guidelines Part-2

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