Clinically useful spirometry in preschool-aged children: evaluation of the 2007 American Thoracic Society Guidelines.
Clinically useful spirometry in preschool-aged children: evaluation of the 2007 American Thoracic Society Guidelines.
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DOI：
10.3109/02770903.2010.485664
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发表时间：
2010-09
期刊：
影响因子：
--
通讯作者：
Phipatanakul W
中科院分区：
文献类型：
--
作者：
Gaffin JM;Shotola NL;Martin TR;Phipatanakul W
2007年，美国胸科学会（ATS）推荐了评估学龄前儿童肺功能测定的可接受性和可重复性指南。作者的目的是确定肺功能测定的可行性，在这个年龄组的儿童进行肺功能测定首次在忙碌的临床实践。从波士顿儿童医院肺功能测试（PFT）数据库中选择4至5岁儿童的首次肺功能测定。如果流量-容积环显示快速上升和平稳下降;后外推容积（Vbe），即受试者在强制动作前泄漏的容积，≤80 ml且为用力肺活量（FVC）的12.5%;呼气流量停止点≤呼气峰流速（PEFR）的10%，则认为动作可接受。通过另一个可接受的动作确定重复性，用力呼气量（t秒）和FVC在最佳可接受动作的10%或0.1 L范围内。事后分析比较了哮喘和囊性纤维化患者的肺功能测定值与正常值。248名学龄前儿童在2006年8月26日至2008年8月25日期间首次进行肺功能测定。在82.3%（n = 204）的测试中发现至少一种技术上可接受的操作。总体而言，54%的儿童能够根据ATS标准进行可接受和可重复的肺功能测定。哮喘或囊性纤维化儿童的肺功能测定值与健康对照组无显著差异。然而，高达29%的整个队列显示至少一个异常的肺功能测定值。在忙碌的临床环境中，许多学龄前儿童能够在正常条件下进行技术上可接受的和可重复的肺量测定。肺功能测定可能是一个有用的屏幕异常肺功能在这个年龄组。
In 2007 the American Thoracic Society (ATS) recommended guidelines for acceptability and repeatability for assessing spirometry in preschool children. The authors aim to determine the feasibility of spirometry among children in this age group performing spirometry for the first time in a busy clinical practice. First-time spirometry for children age 4 to 5 years old was selected from the Children’s Hospital Boston Pulmonary Function Test (PFT) database. Maneuvers were deemed acceptable if the flow-volume loop showed rapid rise and smooth descent; the back extrapolated volume (Vbe), the volume leaked by a subject prior to the forced maneuver, was ≤80 ml and 12.5% of forced vital capacity (FVC); and cessation of expiratory flow was at a point ≤10% of peak expiratory flow rate (PEFR). Repeatability was determined by another acceptable maneuver with forced expiratory volume in t seconds (FEVt) and FVC within 10% or 0.1 L of the best acceptable maneuver. Post hoc analysis compared spirometry values for those with asthma and cystic fibrosis to normative values. Two hundred and forty-eight preschool children performed spirometry for the first time between August 26, 2006, and August 25, 2008. At least one technically acceptable maneuver was found in 82.3% (n = 204) of the tests performed. Overall, 54% of children were able to perform acceptable and repeatable spirometry based on the ATS criteria. Children with asthma or cystic fibrosis did not have spirometry values that differed significantly from healthy controls. However, up to 29% of the overall cohort displayed at least one abnormal spirometry value. Many preschool-aged children are able to perform technically acceptable and repeatable spirometry under normal conditions in a busy clinical setting. Spirometry may be a useful screen for abnormal lung function in this age group.
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