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Reference equations for the interpretation of forced expiratory and plethysmographic measurements in infants

Zihang Lu1,2, Rachel E Foong1,3, Krzysztof Kowalik1

  • 1Division of Respiratory Medicine, Department of Pediatrics, and Program in Translational Medicine, SickKids Research Institute, The Hospital for Sick Children, University of Toronto, Toronto, Canada.

Pediatric Pulmonology
|May 24, 2018
PubMed

Insights

New reference equations for infant pulmonary function testing are needed. Published equations do not fit data from the CHILD Study, potentially misclassifying healthy infants. New, specific equations are provided.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Biomedical Engineering

Background:

  • Pulmonary function testing (PFT) is crucial for diagnosing and managing pediatric respiratory diseases.
  • Accurate interpretation of infant PFT data requires appropriate reference equations derived from healthy children.
  • Existing reference equations may not align with current PFT equipment and diverse populations.

Purpose of the Study:

  • To evaluate the similarity of published reference equations to infant PFT data from the Canadian Healthy Infant Longitudinal Development (CHILD) Study.
  • To develop and provide new, equipment-specific reference equations for infant PFT using data from the CHILD Study.

Main Methods:

  • Reference equations were developed for five PFT variables (FEV0.5, FVC, FEF25-75, FEV0.5/FVC ratio, FRCpleth) using the nSpire system.
  • Data from 131-161 infants (3-24 months) in the CHILD Study were analyzed.
  • New equations were compared against previously published reference equations.

Main Results:

  • Age and length significantly influenced both forced flow and plethysmographic measures in infants.
  • Ethnicity showed a significant association with FEV0.5/FVC and FEF25-75 measures.
  • Published reference equations showed poor fit to the CHILD Study data, leading to misclassification of healthy infants.

Conclusions:

  • There is a need for population- and device-specific reference data for infant PFT.
  • The study provides new, equipment-specific reference equations for healthy infants, aiding interpretation in other centers using similar equipment.
Abstract

Keywords:
CHILD Studyforced flow measuresinfant pulmonary function testingplethysmographyreference equations

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