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Reference equations for the interpretation of forced expiratory and plethysmographic measurements in infants
Author(s) -
Lu Zihang,
Foong Rachel E.,
Kowalik Krzysztof,
Moraes Theo J.,
Dubeau Aimee,
Lefebvre Diana,
Davis Stephanie D.,
Balkovec Susan,
Becker Allan,
Mandhane Piush,
Turvey Stuart E.,
Lou Wendy,
Sears Malcolm R.,
Ratjen Felix,
Subbarao Padmaja
Publication year - 2018
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24063
Subject(s) - plethysmograph , medicine , vital capacity , pulmonary function testing , population , generalized estimating equation , lung function , cardiology , statistics , lung , mathematics , environmental health , diffusing capacity
Background Pulmonary function testing is commonly performed for diagnosis and clinical management of respiratory diseases. It is important to use appropriate reference equations from healthy subjects for interpretation of data from infants with lung disease. This study aimed to determine if published reference equations were similar to forced flow measures and plethysmographic infant pulmonary function testing data collected in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Methods Reference equations for five pulmonary function variables (FEV 0.5 , FVC, FEF 25‐75 , FEV 0.5 /FVC ratio and plethysmography (FRC pleth )) were developed using data from the nSpire system. New reference equations developed using healthy data from the CHILD Study were compared to previously published reference equations for forced flow and plethysmographic measures. Results The current analysis included 131 infants (on 181 test occasions) with forced flow measures and 161 infants (on 246 test occasions) with plethysmography measures, aged 3–24 months. Age and length were major determinants of both forced flow and plethysmography measures. In addition, ethnicity (Caucasian vs non‐Caucasian) was significantly associated with FEV 0.5 /FVC and FEF 25‐75 measures. We found that the published reference equations based on custom‐built equipment or commercially available systems provided poor fit to our current pulmonary function testing data, resulting in placing a large proportion of our healthy population outside the normal ranges. Conclusions Our current data support the need for population and device specific reference data for infant pulmonary function studies. By deriving new equipment‐specific reference equations for our healthy population, we provide normative data to other centers utilizing this equipment.

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