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Comparison of a handheld turbine spirometer to conventional spirometry in children with cystic fibrosis
Author(s) -
Avdimiretz Nicholas,
Wilson David,
Grasemann Hartmut
Publication year - 2020
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.24743
Subject(s) - spirometer , medicine , spirometry , ambulatory , vital capacity , limits of agreement , physical therapy , cardiology , asthma , nuclear medicine , lung function , lung , exhaled nitric oxide , diffusing capacity
Background In pediatric cystic fibrosis (CF) ambulatory care, handheld spirometry in individual clinic rooms would improve patient flow and potentially reduce patient‐to‐patient contact. A validation study was conducted to examine the accuracy of an entirely handheld turbine spirometer vs a standard laboratory device in pediatric CF patients. Methods Spirometric data were obtained from 76 CF patients aged less than 18 years in the ambulatory setting using the Micro Loop Spirometer (CareFusion) and compared to same‐day data from conventional laboratory spirometry. Results Linear relationships were obtained between devices, demonstrating good correlation: r = .99, .99, .97, and .82 for forced expiratory volume in 1 second (FEV 1) , forced vital capacity (FVC), FEF 25%‐75% , and peak expiratory flow, respectively ( P < .001 for all). Biases (mean differences between devices) were −65 mL for FEV 1 ( P < .001) and −115 mL for FVC ( P < .001) on the handheld. Bland‐Altman plots demonstrated scatter in bias across all volumes. Limits of agreement (defined as mean ± 2 standard deviations [SD]) were large: +189 to −319 mL for FEV 1 , equating to large limits of agreement for FEV 1 percent predicted of +9.0% to −13.9%. For repeated measurements on the same device on different days, a larger percent SD was obtained with the handheld compared to the conventional spirometer (6.7% vs 5.1%, respectively). Importantly, a relatively large number (15%) demonstrated a decrease in FEV 1 percent predicted of ≥10% on the handheld compared to conventional. Conclusions This suggests that while both devices have passed the recommendations for spirometry testing per American Thoracic Society/European Respiratory Society, handheld turbine vs conventional spirometers may not be used interchangeably in the pediatric CF population.