Spirometry quality in preschool children
DOI:
https://doi.org/10.23938/ASSN.0357Keywords:
Spirometry. Preschool children. Reference values. Quality. Spirometric maneuvers.Abstract
Background. Carrying out quality spirometric maneuvers in preschool children in both the diagnosis and follow-up of respiratory diseases continues to be very scarce. This is due to several reasons, including a lack of consensus on quality criteria and the acceptability of the test. The purpose of this study is therefore to obtain reference norms from a population of healthy preschool children from the Autonomous Community of Navarre (Spain).
Method. A total of 114 healthy preschool children aged between 3 and 7 years of age, without prior experience in carrying out lung function tests, were included.
Results. A total of 76 were able to realize at least two acceptable spirometric maneuvers, and 60 of them maneuvers that were acceptable and reproducible, according to ATS/ERS criteria. This represents a global success percentage of 59%. The most common failing was premature and brusque termination of the spirometric maneuver, followed by an inadequate peak in breathing.
Conclusions. Over half of the preschool children were able to realize quality spirometric maneuvers. Our data make it possible to recommend the proposed quality criteria as being suitable for routine use, and to encourage the use of spirometry in regular clinical practice within the setting of specialized care.Downloads
References
1. GARCÍA-MARCOS L, QUIRÓS AB, HERNÁNDEZ GG, GUILLÉN-GRIMA F, DÍAZ CG, URENA IC et al. Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain. Allergy 2004; 59: 1301-1307.
https://doi.org/10.1111/j.1398-9995.2004.00562.x
2. GEMA: Spanish guide-lines for diagnosis and asthma management. J Invest Alergol Clin Immunol 2010; 20 (S 1): S1.
3. JONES MH, DAVIS SD, GRANT D, CHRISTOPH K, KISLING J, TEPPER RS. Forced expiratory maneuvers in very young children. Assessment of flow limitation. Am J Respir Crit Care Med 1999; 159: 791-795.
https://doi.org/10.1164/ajrccm.159.3.9803001
4. KANENGISER S, DOZOR AJ. Forced expiratory maneuvers in children aged 3 to 5 years. Pediatr Pulmonol 1994; 18: 144-149.
https://doi.org/10.1002/ppul.1950180305
5. MERKUS PJFM, DE JONGSTE JC, STOCKS J. Respiratory function measurements in infants and children. Lung Function Testing: European Respiratory Society Journals Ltd; 2005. pp. 166-194.
https://doi.org/10.1183/1025448x.00031009
6. LUM S, STOCKS J. Forced expiratory manoeuvres. Paediatric Lung Function: European Respiratory Society Journals Ltd; 2010. pp. 46-65.
https://doi.org/10.1183/1025448x.00020909
7. LOWE LA, SIMPSON A, WOODCOCK A, MORRIS J, MURRAY CS, CUSTOVIC A et al. Wheeze Phenotypes and Lung Function in Preschool Children. Am J Respir Crit Care Med 2005; 171: 231-237.
https://doi.org/10.1164/rccm.200406-695OC
8. KUNZLI N, KUNA-DIBBERT B, KEIDEL D, KELLER R, BRANDLI O, SCHINDLER C et al. Longitudinal validity of spirometers--a challenge in longitudinal studies. Swiss Med Wkly 2005; 135: 503-508.
https://doi.org/10.4414/smw.2005.11050
9. BEYDON N, PIN I, MATRAN R, CHAUSSAIN M, BOULE M, ALAIN B et al. Pulmonary function tests in preschool children with asthma. Am J Respir Crit Care Med 2003; 168: 640-644.
https://doi.org/10.1164/rccm.200303-449OC
10. BEYDON N, AMSALLEM F, BELLET M, BOULE M, CHAUSSAIN M, DENJEAN A et al. Pulmonary function tests in preschool children with cystic fibrosis. Am J Respir Crit Care Med 2002; 166: 1099-1104.
https://doi.org/10.1164/rccm.200205-421OC
11. ARETS HG, BRACKEL HJ, VAN DER ENT CK. Forced expiratory manoeuvres in children: do they meet ATS and ERS criteria for spirometry? Eur Respir J 2001; 18: 655-660.
https://doi.org/10.1183/09031936.01.00204301
12. VILOZNI D, BARAK A, EFRATI O, AUGARTEN A, SPRINGER C, YAHAV Y et al. The role of computer games in measuring spirometry in healthy and "asthmatic" preschool children. Chest 2005; 128: 1146-1155.
https://doi.org/10.1378/chest.128.3.1146
13. QUANJER PH, BORSBOOM GJJM, KIVASTIK J, MERKUS PJFM, HANKINSON JL, HOUTHUIJS D et al. Cross-sectional and Longitudinal Spirometry in Children and Adolescents: Interpretative Strategies. Am J Respir Crit Care Med 2008; 178: 1262-1270.
https://doi.org/10.1164/rccm.200805-700OC
14. BEYDON N, DAVIS SD, LOMBARDI E, ALLEN JL, ARETS HG, AURORA P et al. An official American Thoracic Society/European Respiratory Society statement: pulmonary function testing in preschool children. Am J Respir Crit Care Med 2007; 175: 1304-1345.
https://doi.org/10.1164/rccm.200605-642ST
15. AURORA P, STOCKS J, OLIVER C, SAUNDERS C, CASTLE R, CHAZIPARASIDIS G et al. Quality control for spirometry in preschool children with and without lung disease. Am J Respir Crit Care Med 2004; 169: 1152-1159.
https://doi.org/10.1164/rccm.200310-1453OC
16. PESANT C, SANTSCHI M, PRAUD J-P, GEOFFROY M, NIYONSENGA T, VLACHOS-MAYER H. Spirometric pulmonary function in 3- to 5-year-old children. Pediatr Pulmonol 2007; 42: 263-271.
https://doi.org/10.1002/ppul.20564
17. GARDNER RM, CLAUSEN JL, EPLER G, HANKINSON JL, PERMUTT S, PLUMMER AL. Pulmonary function laboratory personnel qualifications. Am Rev Respir Dis 1986; 134: 623-624.
18. BORG BM, HARTLEY MF, FISHER MT, THOMPSON BR. Spirometry Training Does Not Guarantee Valid Results. Respiratory Care 2010; 55: 689-694.
19. OLAGUIBEL JM, ALVAREZ-PUEBLA MJ, ANDA M, GOMEZ B, GARCIA BE, TABAR AI et al. Comparative analysis of the bronchodilator response measured by impulse oscillometry (IOS), spirometry and body plethysmography in asthmatic children. J Investig Allergol Clin Immunol 2005; 15: 102-106.
20. OLAGUIBEL JM, PUEBLA MJA, ACERO S, FIGUEROA BEG, BARRERA AR, TABAR AI. Utility of the study of non-specific bronchial response for monitoring bronchial asthma. J Invest Allergoly & Clinical Immunology 1997; 7: 284-285.
21. OLAGUIBEL RIVERA JM, ALVAREZ-PUEBLA MJ, PUY URIBE SAN MARTIN M, TALLENS ARMAND ML. Duration of asthma and lung function in life-long nonsmoking adults. Journal of investigational allergology & clinical immunology: official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunologia 2007; 17: 236-241.
22. EIGEN H, BIELER H, GRANT D, CHRISTOPH K, TERRILL D, HEILMAN DK et al. Spirometric pulmonary function in healthy preschool children. Am J Respir Crit Care Med 2001; 163(3 Pt 1): 619-623.
https://doi.org/10.1164/ajrccm.163.3.2002054
23. NYSTAD W, SAMUELSEN SO, NAFSTAD P, EDVARDSEN E, STENSRUD T, JAAKKOLA JJK. Feasibility of measuring lung function in preschool children. Thorax 2002; 57: 1021-1027.
https://doi.org/10.1136/thorax.57.12.1021
24. PÉREZ-YARZA EG, VILLA JR, COBOS N, NAVARRO M, SALCEDO A, MARTÍN C et al. Espirometría forzada en preescolares sanos bajo las recomendaciones de la ATS/ERS: estudio CANDELA. Anales de pediatría 2009; 70: 3-11.
https://doi.org/10.1016/j.anpedi.2008.10.003
25. STANOJEVIC S, WADE A, LUM S, STOCKS J. Reference equations for pulmonary function tests in preschool children: A review. Pediatr Pulmonol 2007; 42: 962-972.
https://doi.org/10.1002/ppul.20691
26. STANOJEVIC S, WADE A, COLE TJ, LUM S, CUSTOVIC A, SILVERMAN M et al. Spirometry Centile Charts for Young Caucasian Children. Am J Respir Crit Care Med 2009; 180: 547-552.
https://doi.org/10.1164/rccm.200903-0323OC
27. PELLEGRINO R, VIEGI G, BRUSASCO V, CRAPO RO, BURGOS F, CASABURI R et al. Interpretative strategies for lung function tests. Eur Respir J 2005; 26: 948-968.
https://doi.org/10.1183/09031936.05.00035205
28. QUANJER PH, STANOJEVIC S, COLE TJ, BAUR X, HALL GL, CULVER BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Europ Resp J 2012; 40: 1324-1343.
https://doi.org/10.1183/09031936.00080312
29. STANOJEVIC S, WADE A, STOCKS J. Reference values for lung function: past, present and future. Eur Resp J 2010; 36: 12-19.
https://doi.org/10.1183/09031936.00143209
30. ZAPLETAL A, CHALUPOVA J. Forced expiratory parameters in healthy preschool children (3-6 years of age). Pediatr Pulmonol 2003; 35: 200-207.
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