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Forced expiratory parameters in healthy preschool children (3-6 years of age)
1Second Department of Pediatrics, University Hospital Motol, Prague, Czech Republic. alois.zapletal@lmotol.cuni.cz
Insights
This study establishes crucial reference values for lung function in healthy preschool children, showing these parameters correlate strongly with body height, not age. These findings aid in diagnosing respiratory issues in young children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Biometry
Background:
- Accurate assessment of lung function in preschool children is vital for early detection of respiratory diseases.
- Establishing normative data is challenging due to the developmental stage of young children.
Purpose of the Study:
- To establish reliable reference values for key forced expiratory parameters in healthy preschool children.
- To provide a basis for identifying lung function abnormalities in this age group.
- To investigate the relationship between lung function parameters and anthropometric measurements.
Main Methods:
- Cross-sectional measurement of maximum expiratory flow-volume (MEFV) curves in 173 healthy preschool children (3-6 years).
- Calculation of parameters including MEF(25), MEF(50), MEF(75), PEF, FEV(1), FVC, and A(ex).
- Statistical analysis using power regression to correlate parameters with body height and age.
Main Results:
- A majority (62%) of preschool children could generate accurate MEFV curves.
- Lung function parameters showed significant nonlinear correlation with body height (P < 0.0001), but weaker correlation with age.
- No significant gender differences were observed for the studied parameters.
- Reference values were established using power regression equations, with tables provided for clinical comparison.
Conclusions:
- Reference values for forced expiratory parameters in healthy Caucasian preschool children have been established, primarily based on body height.
- The findings suggest that airway patency increases with body height, as indicated by declining ratios like PEF/FVC.
- These reference values are suitable for assessing lung function abnormalities in preschool children.
Abstract:
In a group of 173 healthy preschool children 3-6 years of age (body height, 90-130 cm; 102 boys and 71 girls) out of total 279 children examined, maximum expiratory flow-volume (MEFV) curves were recorded in cross-sectional measurements. The majority (62%) of preschool children were able to generate an MEFV curve as correctly as older children. From the curves, maximum expiratory flows at 25%, 50%, and 75 % of vital capacity (MEF(25), MEF(50), and MEF(75)), peak expiratory flow (PEF), forced expiratory volume in 1 sec (FEV(1)), forced vital capacity (FVC), and area delineated by MEFV curve (A(ex)) were obtained. The purpose of the study was to establish reference values of forced expiratory parameters in preschool children suitable for assessment of lung function abnormalities in respiratory preschool children. The values of the studied parameters increased nonlinearly and correlated significantly with body height (P < 0.0001); the correlation was much lower with age. A simple power regression equation was calculated for the relationship between each parameter and body height. A best-fit regression equation relating functional parameters and body height was a power function. Based on the obtained regression equations with upper and lower limits, we prepared tables listing reference values of forced expiratory parameters in healthy Caucasian preschool children, against which patients can be compared. No statistically significant gender differences were observed for MEF(25), MEF(50), MEF(75), PEF, FEV(1), FVC, and A(ex) by extrapolation. The reference values were close to those obtained in our older children. A decline of the ratios PEF/FVC, FEV(1)/FVC and MEF/FVC with increasing body height suggested more patent airways in younger and smaller preschool children.