Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children

WANG Qun; REN Yi-Xin; LIU Yong-Ge; HUANG Hui-Jie; XIANG Li

doi:10.7499/j.issn.1008-8830.2015.06.013

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Chinese Journal of Contemporary Pediatrics ›› 2015, Vol. 17 ›› Issue (6) : 590-595. DOI: 10.7499/j.issn.1008-8830.2015.06.013

CLINICAL RESEARCH

Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children

WANG Qun, REN Yi-Xin, LIU Yong-Ge, HUANG Hui-Jie, XIANG Li

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Abstract

Objective To assess the quality control for the maximal expiratory flow-volume (MEFV) curve in school-age children. Methods Eight hundred and sixty-two children who had two or more MEFV manoeuvres were classified into ≥6-year-old (n=379), ≥8-year-old (n=210), ≥10-year-old (n=64), and 12-17-year-old groups (n=109). The parameters of quality control and concordance with quality control criteria for MEFV were compared between the two groups. In addition, patients who were diagnosed with asthma were classified into two groups, one with normal pulmonary function (n=155) and the other with abnormal pulmonary function (n=62), based on the results of spirometry. Differences in the parameters of quality control for spirometry were compared between the two groups. Results Eight hundred and sixty-two children underwent 2 367 MEFV manoeuvres, 97.8% of which met the start of test criterion for backward extrapolated volume (VBE) of less than 0.15 L, with the highest concordance in the ≥6-year-old group and the lowest concordance in the 12-17-year-old group. Three hundred and eighty-one children (44.2%) met the end of test criterion for forced expiratory time (FET) and the concordance in children over 10 years of age was lower than that in children under 10 years of age (P<0.05). Differences in two best forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) manoeuvres were within 150 mL in 91.9% and 84.8%, respectively, of the children. The parameters of quality control for spirometry were better for asthmatic children with abnormal pulmonary function compared with asthmatic children with normal pulmonary function (P<0.05). Conclusions Concordance with the start of test criteria and the manoeuvre repeatability criteria is high, whereas the concordance with the end of test criteria is low. It is suggested that the concordance with the FET criteria should be improved.

Key words

Pulmonary function test / Maximal expiratory flow-volume curve / Quality control / Child

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WANG Qun, REN Yi-Xin, LIU Yong-Ge, HUANG Hui-Jie, XIANG Li. Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children[J]. Chinese Journal of Contemporary Pediatrics. 2015, 17(6): 590-595 https://doi.org/10.7499/j.issn.1008-8830.2015.06.013

References

[1] 张清玲, 郑劲平, 袁本通, 等. 学龄前儿童用力肺活量测定的质量控制分析[J]. 中国实用儿科杂志, 2006(21):259-264.
[2] Arets HG, Brackel HJ, van der Ent CK. Forced expiratory manoeuvres in children:do they meet ATS and ERS criteria for spirometry? [J]. Eur Respir J, 2001, 18(4):655-660.
[3] Muller-Brandes C, Krämer U, Gappa M, et al. LUNOKID:can numerical American Thoracic Society/European Respiratory Society quality criteria replace visual inspection of spirometry?[J]. Eur Respir J, 2014, 43(5):1347-1356.
[4] 张清玲, 郑劲平. 学龄前儿童用力肺活量检测的研究进展[J]. 国际呼吸杂志, 2006, 26(1):67-69.
[5] Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry[J]. Eur Respir J, 2005, 26(2):319-338.
[6] 黄思贤. 重视肺功能检测的研究与临床应用[J]. 实用医学杂志, 2001, 17(8):379-380.
[7] 中华医学会呼吸病学分会肺功能专业组. 肺功能检查指南 (第一部分)—概述及一般要求[J]. 中华结核和呼吸杂志, 2014, 37(6):402-405.
[8] 高怡, 郑劲平, 安嘉颖, 等. 中国大型综合性医院肺量计检查报告质量的多中心调查[J]. 中华结核和呼吸杂志, 2010, 33(4):247-250.
[9] 中华医学会呼吸病学分会肺功能专业组. 肺功能检查指南 (第二部分)—肺量计检查[J]. 中华结核和呼吸杂志, 2014, 37(7):481-486.
[10] 朱蕾, 刘又宁, 于润江. 临床肺功能学[M]. 北京:人民卫生出版社, 2004:63-64.
[11] Gochicoa-Rangel L, Vargas-Domínguez C, García-Mujica ME, et al. Quality of spirometry in 5-to-8-year-old children[J]. Pediatr Pulmonol, 2013, 48(12):1231-1236.
[12] Aurora PI, Stocks J, Oliver C, et al. Quality control for spirometry in preschool children with and without lung disease[J]. Am J Respir Crit Care Med, 2004, 169(10):1152- 1159.
[13] Enright P, Vollmer WM, Lamprecht B, et al. Quality of spirometry tests performed by 9893 adults in 14 countries:the BOLD Study[J]. Respir Med, 2011, 105(10):1507-1515.
[14] Desmond KJ, Allen PD, Demizio DL, et al. Redefining end of test (EOT) criteria for pulmonary function testing in children[J]. Am J Respir Crit Care Med, 1997, 156(2):542-545.
[15] 李硕, 宋欣, 刘传合, 等. 北京市5-14 岁儿童肺通气功能正常值的测定[J]. 中华实用儿科临床杂志, 2013, 28(17):1343- 1346.
[16] 陆艳红, 杨晓蕴, 郝创利. 苏州市区儿童肺通气功能正常值及预测值方程式的建立[J]. 临床儿科杂志, 2012, 30(8):716- 720.
[17] Smith LJ, Arynchyn A, Kalhan R, et al. Spirometry guidelines influence lung function results in a longitudinal study of young adults[J]. Respir Med, 2010, 104(6):858-864.
[18] Nystad W, Samuelsen SO, Nafstad P, et al. Feasibility of measuring lung function in preschool children[J]. Thorax, 2002, 57(12):1021-1027.
[19] Beydon N, Davis SD, Lombardi E, et al. An official american thoracic society/european respiratory society statement:pulmonary function testing in preschool children[J]. Am J Respir Crit Care Med, 2007, 175(12):1304-1345.
[20] Stout JW, Smith K, Zhou C, et al. Learning from a distance:effectiveness of online spirometry training in improving asthma care[J]. Acad Pediatr, 2012, 12(2):88-95.
[21] Latzke-Davis B, Stout J, Smith K, et al. Effectiveness of Spirometry Fundamentals^TM for increasing the proper use of spirometry in patients with asthma and COPD[J]. Prim Care Respir J, 2011, 20(4):441-447.