Spirometric Pulmonary Function in Healthy Preschool Children

Abstract

The purpose of this study was to evaluate spirometric lung function in normal children ages 3 to 6 yr. Spirometric measurements were obtained at nursery and daycare centers by experienced pediatric pulmonary function technicians. Of 307 children recruited, 259 fulfilled our criteria as normal. Of these, 82.6% (214) were able to perform technically acceptable and reproducible maneuvers during a testing session limited to 15 min. The regression model with log-transformed parameters of pulmonary function and height had the best correlations. After accounting for height in the model, other physical traits and health questionnaire items did not contribute significantly. PEFR, FVC, FEV1, and FEF25-75 all increased with increasing height; correlation coefficients were 0.73, 0.93, 0.92, and 0.67, respectively. The group mean coefficients of variation for replicate measurements of PEFR, FVC, FEV1, and FEF25-75 were 7.8%, 2.5%, 2.7%, and 8.3%, respectively. There was a significant decrease in the ratio FEV1/FVC with increasing height; the mean predicted FEV1/FVC was 0.97 at 90 cm height and 0.89 at 125 cm height. In conclusion, reproducible spirometry can be obtained in the majority of preschool children and has the potential to improve our assessment and management of pulmonary disease.

Paediatric spirometry guideline of the South African Thoracic Society: Part 1

“…An initial period of training is essential. [4,7,12] It is recommended to start testing patients at a young age as this provides training in good spirometry performance, which may lead to better results at an earlier age. [13] Personal information such as height, weight, age, gender and racial group should be recorded for each patient.…”

Diagnosis and treatment of wheezing and asthma in young children

“…7 However lung function test in young children requires a specialized PFT laboratory having high quality spirometer with appropriate software and well trained personnel. 8 Infant and toddlers may need to be sedated for this procedure but the developing country like Bangladesh do not have this kind of laboratory facilities.…”

Efeito da terminação precoce da expiração nos parâmetros espirométricos em crianças pré-escolares saudáveis

“…(1)(2)(3)(4)(5)(6)(7)(8)(9) The publication of reference values and study reports, showing that 40-90% of preschool children can perform spirometry appropriately, has promoted its use in clinical practice. (1)(2)(3)(4)(5)(6)(7)(8) The acceptability criteria for spirometry in adults, standardized by the American Thoracic Society (ATS), (10) cannot be applied to children, especially because of the brevity of the expiratory maneuver, usually lasting less than 2-3 s. The major technical limitation is early termination of exhalation (ETE), characterized by the sudden interruption of exhalation. To allow for ETE, the following criteria for acceptable curves have been proposed (5,8,9) : minimum flows ≤ 25% of the highest PEF; minimum flows ≤ 10% of the highest PEF; and minimum flows ≤ 0.3 L/s.…”

“…(1)(2)(3)(4)(5)(6)(7)(8) The acceptability criteria for spirometry in adults, standardized by the American Thoracic Society (ATS), (10) cannot be applied to children, especially because of the brevity of the expiratory maneuver, usually lasting less than 2-3 s. The major technical limitation is early termination of exhalation (ETE), characterized by the sudden interruption of exhalation. To allow for ETE, the following criteria for acceptable curves have been proposed (5,8,9) : minimum flows ≤ 25% of the highest PEF; minimum flows ≤ 10% of the highest PEF; and minimum flows ≤ 0.3 L/s. Considering the high frequency of ETE in the spirometric tests of preschool children, the ATS has proposed that the acceptability criteria be relaxed, and that curves with minimum flows ≤ 10% of the highest PEF be accepted.…”

“…Because there is no consensus regarding the criterion for curve termination in this age group, (5,6,8,9) the acceptable tests were divided into three groups, based on the criterion for curve termination, in order to determine the validity of partial maneuvers-no child was classified as belonging to more than one group. For the analysis, we selected only the tests with at least Considering the nETE and ETE≤10 groups collectively and by age (% of those in the sample as a whole), we obtained at least two acceptable curves in 9 children in the 3-year-old group (7.4%); in 36 children in the 4-year-old group (29.5%); and in 65 children in the 5-year-old group (53.3%), demonstrating that acceptability increases with age.…”