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Spirometry in children aged 3 to 5 years: reliability of forced expiratory maneuvers
D Crenesse1, M Berlioz, T Bourrier
1Laboratoire d'Explorations Fonctionnelles Respiratoires Pediatriques, Hopital de l'Archet 2, Nice, France. crenesse.d@chu-nice.fr
Insights
Spirometry in preschoolers is feasible, with over half achieving reproducible forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) using ATS criteria. Trained staff are crucial for reliable pediatric lung function testing.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Spirometry is essential for diagnosing pediatric respiratory conditions.
- Evaluating lung function in preschool children presents unique challenges due to cooperation and technique variability.
Purpose of the Study:
- To assess the feasibility and reproducibility of forced expiratory maneuvers in preschool children undergoing spirometry.
- To determine the most suitable spirometric parameters and criteria for this age group.
Main Methods:
- Retrospective analysis of spirometry tests from 355 preschool children (3-6 years old).
- Evaluation of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and forced expiratory time (FET).
- Application of American Thoracic Society (ATS) criteria for reproducibility (within 0.1 L).
Main Results:
- 55% of children performed reliable spirometry maneuvers with reproducible FEV1 and FVC within 0.1 L.
- FEV1 was not always suitable due to short forced expiratory time (FET) in 21.3% of children.
- ATS criteria for FEV1 and FVC reproducibility were effective in over 70% of children with at least two acceptable tests.
Conclusions:
- Forced expiratory spirometry is feasible in a significant proportion of preschool children with appropriate supervision.
- ATS criteria for FEV1 and FVC reproducibility are preferable for evaluating lung function in this young population.
- Carefully trained pediatric medical staff are vital for obtaining reliable spirometric data in children.
Abstract:
The aim of this study was to evaluate the feasibility and reproducibility of forced expiratory maneuvers during standard spirometric evaluation in preschool children. Among 570 young children attending our laboratory, we retrospectively selected 355 patients (14% 3-4-year-olds, 48% 4-5-year-olds, and 38% 5-6-year-olds) who carried out spirometric tests for the first time. The indications for such tests were history of asthma (70%), followed by chronic cough (20%) and other miscellaneous conditions (10%). Eighty-eight, 175, and 92 children performed one, two, and three acceptable tests respectively. Forced expired volume in 1 sec (FEV(1)) and forced vital capacity (FVC) did not differ significantly between attempts in children performing either two or three attempts. Forced expiratory time (FET), i.e., the total time required for the forced expiratory maneuver, was 1.7 +/- 0.1 sec (mean +/- SEM), and was no greater than 1 sec in 21.3% of all tested children. Consequently, FEV(1) does not appear to be well-suited to this age group. Forced expiratory volume in 0.50 and 0.75 sec (FEV(0.5), FEV(0.75)) were thus measured in the group of children performing three attempts (n = 92), and there was no statistical difference between attempts. In 267 children performing two or three tests, the ATS criteria of reproducing FEV(1) and FVC within