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Infant spirometry as a predictor of lung function at early childhood in cystic fibrosis patients

M Pollak1, M Shaw2, S Balkovec1

  • 1Division of Respiratory Medicine, Hospital for Sick Children, Toronto, ON, Canada.

Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society
|September 21, 2020
PubMed

Insights

Pulmonary function tests in infants using the raised volume rapid thoracoabdominal compression (RVRTC) technique do not predict early school-age lung function in children with cystic fibrosis. Routine infant RVRTC testing may not be clinically useful for predicting future respiratory health.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Cystic Fibrosis Research

Background:

  • Infant pulmonary function testing (PFT) with raised volume rapid thoracoabdominal compression (RVRTC) requires sedation and is time-intensive.
  • Many cystic fibrosis (CF) centers lack necessary equipment, and the routine utility of infant PFT is uncertain.
  • The predictive value of early RVRTC testing for later lung function in children with CF needs evaluation.

Purpose of the Study:

  • To determine if RVRTC tests performed in infancy can predict spirometry outcomes at early school age in children with CF.
  • To assess the correlation between infant forced expiratory flow measures and school-age spirometry.
  • To investigate the clinical utility of routine infant PFT in managing CF.

Main Methods:

  • Compared RVRTC-based forced expiratory flow measures in infants with first adequate spirometry at school age.
  • Tests were conducted during routine clinic visits and results expressed as age-related z-scores.
  • Analysis included only test occasions where patients were clinically stable.

Main Results:

  • A weak correlation was found between infant FEV0.5 and early school-age FEV1 (R=0.29, p=0.05).
  • Only one of four infants with significantly low infant zFEV0.5 remained below the limit at school age.
  • Changes in spirometry from infancy to childhood were negatively correlated with baseline FEV0.5, indicating that initial values influenced changes.

Conclusions:

  • Infant RVRTC measures did not reliably predict pulmonary function at early school age.
  • The lack of predictive power may be attributed to a high proportion of normal forced expiratory flow measures at both infant and school-age testing points.
  • Routine infant RVRTC testing may have limited utility for predicting long-term respiratory outcomes in children with CF.
Abstract

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