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Rethinking early childhood spirometry: integrated solutions for technical, psychological and interpretative barriers

Radu Marian Gheorghiu1,2, Iustina Violeta Stan1,2

  • 1National Institute for Mother and Child Health "Alessandrescu-Rusescu", Bucharest, Romania.

Breathe (Sheffield, England)
|October 16, 2025
PubMed

Insights

Preschool spirometry requires tailored reference values and specific equipment for accurate lung function testing in young children. Enhancing interpretation involves expanding global reference norms and using AI for quality control.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology

Background:

  • Spirometry is crucial for diagnosing pediatric lung diseases.
  • Current spirometry methods face challenges in preschool-aged children due to physiological and technical limitations.

Purpose of the Study:

  • To outline essential components for effective preschool spirometry.
  • To propose improvements for accurate interpretation of pediatric lung function tests.

Main Methods:

  • Review of existing literature and clinical guidelines for pediatric spirometry.
  • Identification of key factors influencing test quality and interpretation in young children.
  • Recommendations for hardware, quality control, and reference value expansion.

Main Results:

  • Preschool spirometry necessitates age-tailored Forced Expiratory Volume in 1 second (FEVt) indices and limits.
  • Low-dead-space hardware, AI-assisted spirometry quality control (QC), physician-led coaching, and caregiver preparation are vital.
  • Expansion of Global Lung Initiative (GLI)-Junior reference norms is recommended to strengthen interpretation.

Conclusions:

  • Optimizing preschool spirometry involves a multi-faceted approach including tailored indices, advanced technology, and robust reference data.
  • These improvements are critical for reliable diagnosis and management of respiratory conditions in young children.

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