The Quality of Spirometric Measurements in Children Younger than 10 Years of Age in the Light of Recommendations

Introduction: In 2005 the European Respiratory Society/American Thoracic Society (ERS/ATS) published an updated document on the standardization of spirometry (European Respiratory Journal 2005; 26: 319–338). It defines criteria for the acceptability of spirometric measurements. The aim of this retrospective study was to assess the adherence to those standards of flow-volume measurements in children younger than 10 years of age. Material and methods: The analysis was carried out on the results obtained from 233 children aged 4.2–10 years, referred to a spirometric lab during a period of three months. Results: 116 children (all but one preschool) did not cooperate; the results of the 117 who completed the procedure of flow-volume measurement were analysed using ERS/ATS criteria. 80.3% of the children had back extrapolated volume (Vbe) within the defined limit, but only 23.9% had forced expiratory time > 3 s. FEV₁ and FVC were repeatable in 78.6% of the children. When these three criteria were used together, the measurements were acceptable according to ATS/ERS recommendations in 17.1% of the children. Elimination of the forced expiratory time criterion has further increased theirnumber to 63.2%. Conclusions: Specific recommendations for children should be developed, as the current requirements appear too restrictive, especially regarding the time of forced expiration.