Diagnosing pediatric asthma is challenging and requires the evaluation of symptoms, inflammation, and lung function. Spirometry, which is commonly used to evaluate lung function in asthma, is difficult to obtain from young pediatric patients and frequently not possible to obtain from patients under 5 years of age. This is also true for the fraction of exhaled nitric oxide (FENO) measurement, which can indicate type 2 airway inflammation in asthma, and controversy has existed regarding the appropriate use of FENO measurement in asthma diagnosis and monitoring. Impulse oscillometry can be used to evaluate lung function and may be easier to perform than spirometry for pediatric patients. This narrative review evaluates the recent guidelines for diagnosis and monitoring of pediatric asthma. It also provides an overview of the use of FENO measurement and impulse oscillometry in pediatric asthma. A panel discussion of the role of FENO measurement and impulse oscillometry in pediatric asthma concludes this article.
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