Journal
EUROPEAN RESPIRATORY JOURNAL
Volume 18, Issue 4, Pages 655-660Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
DOI: 10.1183/09031936.01.00204301
Keywords
American Thoracic Society; criteria; children; European Respiratory Society criteria; maximal expiratory flow/volume curves; spirometry
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The aim of this study was to evaluate the applicability of American Thoracic Society and European Respiratory Society criteria for spirometry in children. Maximal expiratory flow/volume (MEFV) measurements from 446 school-age children, experienced in performing MEFV manoeuvres, were studied and acceptability (start-of-test (backward extrapolated volume as a percentage of forced vital capacity (FVC) (Vbe%FVC) or as an absolute value (Vbe), end-of-test (forced expiratory time (FET)) and reproducibility criteria (absolute and percentage difference between best and second-best FVC and forced expiratory volume in one second (FEV1) (Delta FVC, Delta FVC%, Delta FEV1 and Delta FEV1 %)) were applied to these manoeuvres. The Vbe%FVC criterion was met by 91.5%,, the Vbe<0.15 L criterion by 94.8%, and the Vbe <0.10 L by 60.1% of children. Vbe <0.15 L appeared to be a more useful parameter than Vbe%FVC. The FET criterion was met by only 15.3% of children. FVC <0.2 L and FEV1 <0.2 L were met by 97.1%, and 98.4%, and FVC <0.1 L and FEV1 <0.1 L by 79.8% and 84.3% of the children, respectively. These criteria appeared to be less useful compared to percentage criteria (FVC %) and Delta FEV1 %). Even experienced children did not meet all international criteria for spirometry. However, most of their MEFV curves are useful for interpretation. Based on the performance of these children, a re-evaluation of criteria for maximal expiratory flow/volume measurements in children is proposed.
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