Document Detail

Potential misinterpretation of infant lung function unless prospective healthy controls are studied.
MedLine Citation:
PMID:  20648666     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study aimed to assess the validity of published reference equations for forced expiratory flow-volume (FEFV) data in infants when using current, commercially available equipment, and how this could impact on interpretation of results from infants with lung disease.
METHODS: The Jaeger Masterscreen BabyBody (v4.67) equipment was used to perform partial and raised volume FEFV maneuvers in healthy infants and those with cystic fibrosis (CF). Results were initially expressed as Z-scores using published reference equations. Multilevel modeling was used to calculate differences, if any, from predicted scores in healthy infants.
RESULTS: Data were available from 66 healthy full term infants on 89 test occasions; [median (range) postnatal age 49.4 (12-101) weeks. All FEFV outcomes were significantly lower than predicted, with mean (SD) Z-score differences of -0.4 (1.1) for FVC; -0.6 (1.0) for FEV(0.5); -1.0 (1.0) for FEF(25-75) and -1.4 (1.1) for V'(maxFRC). After adjustments using multilevel modeling, mean Z-scores were within 0.1 (SD approximately 1.0) predicted for all outcomes in healthy infants. Among 50 infants with CF, studied on 85 test occasions, results were "abnormal" (<-1.96 Z-scores) on 35 (41%) and 37 (45%) test occasions for FEV(0.5) and FEF(25-75), respectively, when using published equations. This fell to 24 (28%) and 20 (24%), respectively, after adjustment.
CONCLUSIONS: Dependence on published equations for interpreting FEFV data in infants may lead to misinterpretation of lung function status, which could impact adversely both in the research setting and on clinical management. Use of a contemporary control group or establishment of equipment-specific reference data is essential for meaningful interpretation of infant lung function data.
Sooky Lum; Ah-Fong Hoo; Georg Hulskamp; Angie Wade; Janet Stocks
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  45     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-15     Revised Date:  2011-01-11    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  906-13     Citation Subset:  IM    
Copyright Information:
(c) 2010 Wiley-Liss, Inc.
Portex Unit, Respiratory Physiology and Medicine, UCL, Institute of Child Health, London, UK.
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MeSH Terms
Case-Control Studies
Cystic Fibrosis / complications,  diagnosis*
Forced Expiratory Flow Rates*
Forced Expiratory Volume*
Lung Diseases / diagnosis*,  etiology
Mathematical Computing
Prospective Studies
Reference Values
Grant Support
//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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