Am. J. Respir. Crit. Care Med., Volume 161, Number 2, February 2000, 353-359

Forced Expiratory Flows and Volumes in Infants
Normative Data and Lung Growth

MARCUS JONES, ROBERT CASTILE, STEPHANIE DAVIS, JEFF KISLING, DAVE FILBRUN, ROBERT FLUCKE, AMY GOLDSTEIN, CHRISTINE EMSLEY, WALTER AMBROSIUS, and ROBERT S. TEPPER

Department of Pediatrics, James Whitcomb Riley Hospital for Children, and Department of Bio-statistics, Indiana University Medical Center, Indianapolis, Indiana; and Columbus Children's Hospital, Ohio State University, Columbus, Ohio

Forced expiratory flows (FEF) can be measured in infants from lung volumes initiated near total lung capacity. In order to establish reference values and to evaluate lung growth, we obtained measurements in 155 healthy subjects between 3 and 149 wk of age. Forced vital capacity (FVC) was highly correlated with body length; however, after accounting for length, age was also significant. When subjects were divided at the median age (40 wk) younger compared with older subjects had a significantly larger slope for length (3.7 versus 2.8; p = 0.002). The flow parameters (FEF₅₀, FEF₇₅, FEF₈₅, and FEF_25-75) were highly correlated with length, and those infants whose mothers smoked had lower flows. For FEF₇₅, male subjects had lower flows than female subjects. The relationship between FEF and volume was assessed using FEV_0.5/FVC, which decreased with increasing length. Smaller subjects emptied their lung volume proportionately faster. We conclude that our study provides reference values for this age group and demonstrates that smoke-exposed infants and male subjects have decreased FEF. In addition, our findings indicate that lung volume increases most rapidly during the first year of life and that airways are large relative to lung volume very early in life. Jones M, Castile R, Davis S, Kisling J, Filbrun D, Flucke R, Goldstein A, Emsley C, Ambrosius W, Tepper RS. Forced expiratory flows and volumes in infants: normative data and lung growth.

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