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. 2002 Dec;57(12):1021–1027. doi: 10.1136/thorax.57.12.1021

Feasibility of measuring lung function in preschool children

W Nystad 1, S Samuelsen 1, P Nafstad 1, E Edvardsen 1, T Stensrud 1, J Jaakkola 1
PMCID: PMC1758804  PMID: 12454295

Abstract

Background: There have been difficulties in applying spirometric tests to children of preschool age.

Methods: The feasibility of measuring lung function was examined in 652 children aged 3–6 years using dynamic spirometry with an animation programme and the guidelines approved by the European Respiratory Society.

Results: Data from 603 (92%) children with at least two acceptable forced expiratory manoeuvres were analysed; 408 (68%) achieved at least three acceptable manoeuvres. Children with only two acceptable manoeuvres were younger, shorter, and weighed less (p<0.001). The lower levels of lung function in this group were partly explained by body size. 63% of those with three acceptable manoeuvres had a difference of ≤5% between the highest and second highest forced expiratory volume in 1 second (FEV1); when a difference of ≤10% was applied, 91% of the children were included. A similar trend was seen for forced vital capacity (FVC). The acceptability and reproducibility increased with increasing age, and levels of lung function increased linearly with age. The linear regression model showed that standing height was a satisfactory predictor of lung function; the explained fraction of variance (R2) was 59% for FEV1. Most FVC manoeuvres in children older than 3 years were acceptable and reproducible.

Conclusions: Spirometric testing is feasible in preschool children and may be useful for both clinical practice and research. This study may fill the deficiency in reference values for European preschool children.

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Selected References

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  1. Cotes J. E., Chinn D. J., Reed J. W. Lung function testing: methods and reference values for forced expiratory volume (FEV1) and transfer factor (TL). Occup Environ Med. 1997 Jul;54(7):457–465. doi: 10.1136/oem.54.7.457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Crenesse D., Berlioz M., Bourrier T., Albertini M. Spirometry in children aged 3 to 5 years: reliability of forced expiratory maneuvers. Pediatr Pulmonol. 2001 Jul;32(1):56–61. doi: 10.1002/ppul.1089. [DOI] [PubMed] [Google Scholar]
  3. Dockery D. W., Berkey C. S., Ware J. H., Speizer F. E., Ferris B. G., Jr Distribution of forced vital capacity and forced expiratory volume in one second in children 6 to 11 years of age. Am Rev Respir Dis. 1983 Sep;128(3):405–412. doi: 10.1164/arrd.1983.128.3.405. [DOI] [PubMed] [Google Scholar]
  4. Eigen H., Bieler H., Grant D., Christoph K., Terrill D., Heilman D. K., Ambrosius W. T., Tepper R. S. Spirometric pulmonary function in healthy preschool children. Am J Respir Crit Care Med. 2001 Mar;163(3 Pt 1):619–623. doi: 10.1164/ajrccm.163.3.2002054. [DOI] [PubMed] [Google Scholar]
  5. Gold D. R., Wypij D., Wang X., Speizer F. E., Pugh M., Ware J. H., Ferris B. G., Jr, Dockery D. W. Gender- and race-specific effects of asthma and wheeze on level and growth of lung function in children in six U.S. cities. Am J Respir Crit Care Med. 1994 May;149(5):1198–1208. doi: 10.1164/ajrccm.149.5.8173760. [DOI] [PubMed] [Google Scholar]
  6. Hibbert M. E., Lannigan A., Landau L. I., Phelan P. D. Lung function values from a longitudinal study of healthy children and adolescents. Pediatr Pulmonol. 1989;7(2):101–109. doi: 10.1002/ppul.1950070209. [DOI] [PubMed] [Google Scholar]
  7. Humerfelt S., Eide G. E., Kvåle G., Gulsvik A. Predictors of spirometric test failure: a comparison of the 1983 and 1993 acceptability criteria from the European Community for Coal and Steel. Occup Environ Med. 1995 Aug;52(8):547–553. doi: 10.1136/oem.52.8.547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. International consensus report on diagnosis and treatment of asthma. National Heart, Lung, and Blood Institute, National Institutes of Health. Bethesda, Maryland 20892. Publication no. 92-3091, March 1992. Eur Respir J. 1992 May;5(5):601–641. [PubMed] [Google Scholar]
  9. Kanengiser S., Dozor A. J. Forced expiratory maneuvers in children aged 3 to 5 years. Pediatr Pulmonol. 1994 Sep;18(3):144–149. doi: 10.1002/ppul.1950180305. [DOI] [PubMed] [Google Scholar]
  10. Kanner R. E., Schenker M. B., Muñoz A., Speizer F. E. Spirometry in children. Methodology for obtaining optimal results for clinical and epidemiologic studies. Am Rev Respir Dis. 1983 Jun;127(6):720–724. doi: 10.1164/arrd.1983.127.6.720. [DOI] [PubMed] [Google Scholar]
  11. Knudson R. J., Lebowitz M. D., Holberg C. J., Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. doi: 10.1164/arrd.1983.127.6.725. [DOI] [PubMed] [Google Scholar]
  12. Lebowitz M. D., Holberg C. J., Knudson R. J., Burrows B. Longitudinal study of pulmonary function development in childhood, adolescence, and early adulthood. Development of pulmonary function. Am Rev Respir Dis. 1987 Jul;136(1):69–75. doi: 10.1164/ajrccm/136.1.69. [DOI] [PubMed] [Google Scholar]
  13. Ng'Ang'a L. W., Ernst P., Jaakkola M. S., Gerardi G., Hanley J. H., Becklake M. R. Spirometric lung function. Distribution and determinants of test failure in a young adult population. Am Rev Respir Dis. 1992 Jan;145(1):48–52. doi: 10.1164/ajrccm/145.1.48. [DOI] [PubMed] [Google Scholar]
  14. Sly P. D., Robertson C. F. A review of pulmonary function testing in children. J Asthma. 1990;27(3):137–147. doi: 10.3109/02770909009073314. [DOI] [PubMed] [Google Scholar]
  15. Studnicka M., Frischer T., Neumann M. Determinants of reproducibility of lung function tests in children aged 7 to 10 years. Pediatr Pulmonol. 1998 Apr;25(4):238–243. doi: 10.1002/(sici)1099-0496(199804)25:4<238::aid-ppul4>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  16. Vilozni D., Barker M., Jellouschek H., Heimann G., Blau H. An interactive computer-animated system (SpiroGame) facilitates spirometry in preschool children. Am J Respir Crit Care Med. 2001 Dec 15;164(12):2200–2205. doi: 10.1164/ajrccm.164.12.2101002. [DOI] [PubMed] [Google Scholar]
  17. Wang X., Dockery D. W., Wypij D., Fay M. E., Ferris B. G., Jr Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol. 1993 Feb;15(2):75–88. doi: 10.1002/ppul.1950150204. [DOI] [PubMed] [Google Scholar]
  18. Warwick W. J. Pulmonary function in healthy Minnesota children. Minn Med. 1977 Jun;60(5):435–440. [PubMed] [Google Scholar]

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