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Sensitivity of Spirometric Measurements to Detect Airway Obstruction in Infants

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

Correspondence and requests for reprints should be addressed to Robert S. Tepper, M.D., Ph.D., Department of Pediatrics Indiana University School of Medicine, James Whitcomb Riley Hospital for Children, 702 Barnhill Drive, Room 4270, Indianapolis, Indiana 46202–5225. E-mail: rtepper{at}iupui.edu

We evaluated the ability of forced expiratory flow volume curves from raised lung volumes to assess airway function among infants with differing severities of respiratory symptoms. Group 1 (n = 33) had previous respiratory symptoms but were currently asymptomatic; group 2 (n = 36) was symptomatic at the time of evaluation. As a control group, we used our previously published sample of 155 healthy infants. Flow volume curves were quantified by FVC, FEF₅₀, FEF₇₅, FEF_25–75, FEV_0.5, and FEV_0.5/FVC, which were expressed as Z scores. All variables except FVC had Z scores that were significantly less than zero and distinguished groups 1 and 2 with progressively lower Z scores. The mean Z scores of the flow variables (FEF_50%, FEF_75%, and FEF_25–75%) were more negative than the Z scores for the timed expired volumes (FEV_0.5 or FEV_0.5/FVC) for both groups. In general, measures of flow identified a greater number of infants with abnormal lung function than measures of timed volume; FEF₅₀ had the highest performance in detecting abnormal lung function. In summary, forced expiratory maneuvers obtained by the raised volume rapid compression technique can discriminate among groups of infants with differing severity of respiratory symptoms, and measures of forced expiratory flows were better than timed expiratory volume in detecting abnormal airway function.

Key Words: infants • spirometry • forced expiratory flows

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