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Feasibility of routine respiratory function testing in preschool children
1Centro de Imunoalergologia, Hospital CUF Descobertas, Lisboa, Portugal. natachalsantos@gmail.com
Insights
Pulmonary function testing in preschool children is feasible in clinical settings. Success rates for spirometry and specific airway resistance increase with age, with modified maneuvers improving evaluation.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Clinical Diagnostics
Background:
- Assessing respiratory function in preschool children presents unique methodological challenges.
- Feasibility in large-scale clinical practice remains an area for investigation.
Purpose of the Study:
- To evaluate the clinical feasibility of pulmonary function testing in preschool children.
- To determine success rates based on age for these tests.
Main Methods:
- Retrospective analysis of 1,239 lung function tests in children aged 2-6 years.
- Utilized whole-body plethysmography for specific airway resistance (sRaw) and animated spirometry.
- Tests were conducted before and after bronchodilator administration, adhering to ATS/ERS criteria.
Main Results:
- 88% of spirometry tests met acceptability criteria, and 79% of sRaw measurements were successful.
- Full FEV(1) results were obtained in 65% of tests.
- Modified spirometric maneuvers (FEV(0.5), FEV(0.75)) increased successful evaluations.
Conclusions:
- Spirometry and sRaw assessment are viable in preschool children within a clinical context.
- Test success rates improve with increasing age.
- Reporting spirometric maneuvers with shorter expiratory times enhances diagnostic yield in younger children.
Introduction:
The assessment of respiratory function in preschool children, which has recently been attracting considerable interest, has several methodological particularities. Whether this is feasible in clinical practice with large groups of patients still needs to be investigated.
Aim:
To assess the feasibility of pulmonary function testing in preschool children in clinical practice, and report the degree of success achieved according to age.
Methods:
Retrospective analysis of lung function tests performed in children from 2 to 6 years old at the respiratory function laboratory of CUF Descobertas Hospital between September 2006 and August 2011. Whole-body pletismography without occlusion for specific airway resistance (sRaw) assessment and animated spirometry were performed using the equipment Jaeger 4.65 (Viasys Healthcare), before and after 400 μg of inhaled salbutamol via a spacer device. The research fulfilled international criteria (ATS/ERS) for acceptability and reproducibility.
Results:
Of 1,239 lung function tests performed, 1,092 (88%) had acceptable and reproducible criteria for spirometry (children with a mean age of 4.3±0.91 years; 60.7% male), and 979 (79%) for sRaw measurement. We were able to report FEV(1) in 801 (65%) tests (children with a mean age of 4.5±0.89 years). In 23 (2%) tests it was only possible to report FEV(0.5) (children with a mean age of 3.5±0.67 years) and in 268 (22%) only FEV(0.75) (children with a mean age of 4.0±0.89 years).
Conclusion:
Spirometry and sRaw assessment in preschool children can be used in clinical practice, with an increasing success rate as children get older. Reporting maneuvers of 0.5 or 0.75 seconds facilitates spirometric evaluation in a larger number of children.
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