Quality of spirometry in 5-to-8-year-old children.

IntroductionAlthough spirometry quality standards for children were proposed by American Thoracic Society/European Respiratory Society (ATS/ERS) in 2007, there is limited information on the percentage of children that fulfill these criteria during routine clinical testing, especially among 5-to-8-year-olds. Aims of the Studyto report the percentage of children that met the current 2007 ATS/ERS quality criteria; explore factors potentially associated with poor quality spirometry; and ascertain the repeatability of forced expiratory volume at 0.5sec (FEV0.5), and at 1sec (FEV1), as well as forced vital capacity (FVC). MethodsWe evaluated the quality of spirometries without bronchodilator use performed at our laboratory in 2008 by 5-to-8-year-old children. FEV1, FEV0.5, FVC, back-extrapolated volume (BEV), forced expiratory time (FET), number of acceptable maneuvers, and repeatability, were computed and the percentage of tests that met the quality criteria standards was calculated. Based on our results, we propose a quality scoring system for spirometry for children that grades on a scale from A-to-F. ResultsThree hundred seventy-six spirometries were reviewed. Mean age was 6.7 years; (53% males); 68% fulfilled the 2005 and 2007 ATS/ERS quality standards; >90% reached a repeatability 150 and 100ml, or 10%, in FVC or FEV1; 87.2% reached FET 3sec; 88% had a BEV 80ml. The 90 percentile repeatability was 120ml for FVC and FEV1. Quality improved with age. ConclusionsOur results support the proposal that a FET 3sec, a BEV 80ml, and repeatability in FEV1 and FVC 100ml, or 10%, be taken into account as elements in quality control for spirometry in children. Pediatr Pulmonol. 2013; 48:1231-1236. (c) 2013 Wiley Periodicals, Inc.