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Spirometry in 3- to 6-Year-Old Children with Cystic Fibrosis

Department of Pediatric Pulmonology and Critical Care, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana

Correspondence and requests for reprints should be addressed to Robert S. Tepper, M.D., Ph.D., Section of Pediatric Pulmonology, James Whitcomb Riley Hospital for Children, 702 Barnhill Drive, Room 2750, Indianapolis, IN 46202-5225. E-mail: rtepper{at}iupui.edu

ABSTRACT

Spirometry is routinely used to assess pulmonary function of older children and adults with cystic fibrosis (CF); however, few data exist concerning the preschool age group. We have reported normative spirometric data for 3- to 6-year-old children. The current study was designed to assess a similarly aged group of clinically stable patients with CF. Thirty-three of 38 children with CF were able to perform 2 or 3 technically acceptable maneuvers. These patients had significantly decreased FVC, FEV₁, FEV₁/FVC, and FEF_25–75 when expressed as z scores (number of SD from predicted): -0.75 ± 1.63, -1.23 ± 1.97, -0.87 ± 1.33, and -0.74 ± 1.63, respectively. There were significant positive correlations of the Brasfield radiological score with FVC and FEV₁ z scores (r² = 0.26, p < 0.01 and r² = 0.24, p < 0.01). In addition, homozygous patients for the F508 mutation had lower z scores for FVC (-1.21 versus 0.47, p < 0.01) and FEV₁ (-1.38 versus 0.21, p < 0.05) than heterozygous patients. Of the 14 patients who had full flow–volume spirometric measurements during infancy, 10 had FEF_25–75 z scores greater than -2 at both evaluations. Our findings suggest that spirometry can successfully be used to assess lung function in preschool children with CF and has the potential for longitudinal assessment from infancy through adulthood.

Key Words: cystic fibrosis • preschool child • spirometry

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