共查询到20条相似文献，搜索用时 22 毫秒
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Nève V Edmé JL Devos P Deschildre A Thumerelle C Santos C Methlin CM Matran M Matran R 《Pediatric pulmonology》2006,41(8):735-743
Spirometry with incentive games was applied to 207 2-5-year-old preschool children (PSC) with asthma in order to refine the quality-control criteria proposed by Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159). The data set in our study was much larger compared to that in Aurora et al. (Am J Respir Crit Care Med 2004;169:1152-159), where 42 children with cystic fibrosis and 37 healthy control were studied. At least two acceptable maneuvers were obtained in 178 (86%) children. Data were focused on 3-5-year-old children (n = 171). The proportion of children achieving a larger number of thresholds for each quality-control criterion (backward-extrapolated volume (Vbe), Vbe in percent of forced vital capacity (FVC, Vbe/FVC), time-to-peak expiratory flow (time-to-PEF), and difference (Delta) between the two FVCs (DeltaFVC), forced expiratory volume in 1 sec (DeltaFEV(1)), and forced expiratory volume in 0.5 sec (DeltaFEV(0.5)) from the two "best" curves) was calculated, and cumulative plots were obtained. The optimal threshold was determined for all ages by derivative function of rate of success-threshold curves, close to the inflexion point. The following thresholds were defined for acceptability: Vbe 相似文献
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Maureen P. Swanney Christopher A. O'Dea Emily R. Ingram Leanne T. Rodwell Brigitte M. Borg for the ANZSRS Spirometry Training Course Working Group 《Respirology (Carlton, Vic.)》2017,22(7):1430-1435
Spirometry training courses are provided by health services and training organizations to enable widespread use of spirometry testing for patient care or for monitoring health. The primary outcome of spirometry training courses should be to enable participants to perform spirometry to international best practice, including testing of subjects, quality assurance and interpretation of results. Where valid results are not achieved or quality assurance programmes identify errors in devices, participants need to be able to adequately manage these issues in accordance with best practice. It is important that potential participants are confident in the integrity of the course they attend and that the course meets their expectations in terms of training. This position statement lists the content that the Australian and New Zealand Society of Respiratory Science (ANZSRS) has identified as required in a spirometry training course to adequately meet the primary outcomes mentioned above. The content requirements outlined in this position statement are based on the current international spirometry standards set out by the American Thoracic Society and European Respiratory Society. Furthermore, recommendations around course delivery for theoretical and practical elements of spirometry testing and post‐course assessment are outlined in this statement. 相似文献
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Loeb JS Blower WC Feldstein JF Koch BA Munlin AL Hardie WD 《Pediatric pulmonology》2008,43(10):1020-1024
Spirometry in pediatrics can be limited by the child's development which is usually related to age. In 2005 the American Thoracic Society (ATS) and European Respiratory Society (ERS) published updated quality control criteria for spirometry. In 2007 the ATS/ERS published specific criteria for spirometry in preschool children 6 years of age and younger. Our primary objective was to determine the influence of age on the ability of children to meet updated spirometry criteria for acceptable and repeatable tests. Our second objective was to determine which criteria are associated with unacceptable tests. Data was prospectively collected over 12 months for children 4-17 years of age performing spirometry for the first time. Unsuccessful tests were analyzed to determine specific criteria not achieved. Three hundred ninety-three studies were collected and 292 (74%) met recently revised ATS/ERS criteria for acceptable and repeatable tests. Acceptable and repeatable test success was not correlated to the gender or race of the children. The percentage of acceptable and repeatable spirometry increased with age rising above 50% by age 6 and reached a plateau with approximately 85% success at age 10. The most common unmet criteria for an unacceptable study among preschool children was glottic closure and non-maximal efforts, while in school-age children was failure to plateau. These data demonstrate most children are able to perform acceptable/repeatable spirometry with their first effort based on revised ATS/ERS criteria. 相似文献
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Background and objective: Changes in specific airway resistance (ΔsRaw) after bronchodilation, as measured by plethysmography and FEV1, are frequently considered to be interchangeable indices of airway obstruction. However, the baseline relationship between these two indices is weak, and the value of ΔsRaw that best predicts FEV1 reversibility in children has yet to be determined. The aim of this study was (i) to establish the sRaw cut‐off value that best distinguishes between positive and negative bronchodilator responses, as measured by FEV1 reversibility; (ii) to determine whether the discrepancy between ΔsRaw and ΔFEV1 might be explained by independent correlations between ΔFEV1 and both ΔsRaw (mainly airway obstruction) and ΔFVC (airway closure); and (iii) to assess the effect of height and age on the relationship between ΔsRaw and ΔFEV1. Methods: A retrospective study was performed in 481 children (median age 10.5 years, range 6.1–17.6) with actual or suspected asthma, for whom sRaw and spirometry data were obtained at baseline and after administration of a bronchodilator. Results: The sRaw cut‐off value that best predicted FEV1 reversibility was a 42% decrease from baseline (P = 0.0001, area under the curve 0.70, sensitivity 55%, specificity 77%) and was independent of height and age. Changes in FEV1 were significantly but independently related to ΔsRaw and ΔFVC (index of air trapping) (r = 0.40, P < 0.0001 and r = 0.39, P < 0.0001, respectively). Conclusions: A 42% decrease in sRaw predicted FEV1 reversibility reasonably well, whereas a smaller decrease in sRaw failed to detect approximately one out of two positive responses detected by FEV1, with no influence of height or age. 相似文献
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Mei Jiang Yi Gao Nan‐Shan Zhong Wei‐Qing Chen Wei‐Jie Guan Jin‐Ping Zheng 《Pediatric pulmonology》2015,50(10):1009-1016
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Spirometry in children aged 3 to 5 years: reliability of forced expiratory maneuvers. 总被引：3，自引：0，他引：3
The aim of this study was to evaluate the feasibility and reproducibility of forced expiratory maneuvers during standard spirometric evaluation in preschool children. Among 570 young children attending our laboratory, we retrospectively selected 355 patients (14% 3-4-year-olds, 48% 4-5-year-olds, and 38% 5-6-year-olds) who carried out spirometric tests for the first time. The indications for such tests were history of asthma (70%), followed by chronic cough (20%) and other miscellaneous conditions (10%). Eighty-eight, 175, and 92 children performed one, two, and three acceptable tests respectively. Forced expired volume in 1 sec (FEV(1)) and forced vital capacity (FVC) did not differ significantly between attempts in children performing either two or three attempts. Forced expiratory time (FET), i.e., the total time required for the forced expiratory maneuver, was 1.7 +/- 0.1 sec (mean +/- SEM), and was no greater than 1 sec in 21.3% of all tested children. Consequently, FEV(1) does not appear to be well-suited to this age group. Forced expiratory volume in 0.50 and 0.75 sec (FEV(0.5), FEV(0.75)) were thus measured in the group of children performing three attempts (n = 92), and there was no statistical difference between attempts. In 267 children performing two or three tests, the ATS criteria of reproducing FEV(1) and FVC within 相似文献
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Melissa K. Cowen Dorothy B. Wakefield Michelle M. Cloutier 《The Journal of asthma》2007,44(9):711-715
National guidelines recommend the use of clinical history and spirometry to determine asthma severity. We examined the usefulness of the six guideline-recommended clinical questions in determining asthma severity and then compared guideline-determined severity to clinician-reported and spirometry-determined severity in a cross-sectional study of 201 children with asthma who were not receiving controller therapy. Four guideline-recommended questions (daytime and nocturnal symptoms, school absenteeism, and exercise impairment) determined asthma severity. Concordance between clinician-reported and spirometry-determined asthma severity was poor (κ = 0.02). Clinical history alone underestimated spirometry-determined disease severity in 27% of children while spirometry results alone underestimated clinician-determined severity in 40% of children. 相似文献
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BACKGROUND: Clinicians frequently rely on reported symptoms and basic pulmonary function testing to assess asthma prevalence in the community. However, given that spirometry results are often normal for asthmatic children and the fact that there is no equivalent word for 'wheeze' in languages other than English, the assessment of asthma prevalence can be troublesome. OBJECTIVE: To evaluate in a population based setting, whether FeNO as a non-invasive marker, contributes to the detection of asthma. METHODS: This cross-sectional study was carried out on primary school children from Northern and Southern Tyrol. FeNO measurements were made using the online single breath technique prior to spirometry. Symptom status including asthma, hayfever and atopic dermatitis was determined by the ISAAC questionnaire. RESULTS: Six hundred and forty-four Tyrolean children aged 8-10 years participated. In terms of FEV1 % predicted, the asthma and hayfever group had significantly lower values compared to the asymptomatic group, the hayfever only, and the atopic dermatitis only groups. For FeNO, participants with asthma and hayfever, asthma and atopic dermatitis, and hayfever only recorded significantly greater FeNO values when compared to the asymptomatic group. Moreover, the asthma and atopic dermatitis group recorded significantly greater FeNO when compared to the asthma only group. Multivariate regression revealed that asthma had a small significant inverse association with FEV1 % predicted for the individual model and when combined with hayfever. For FeNO, each of the individual and combined model analyses achieved significance. CONCLUSION: Although FeNO appears to be influenced by asthma, the presence of other atopic conditions confounds the relationship. Elevated levels of FeNO do not distinguish between asthma and other atopic conditions. Therefore, FeNO does not contribute to the detection of asthma in the community. CLINICAL IMPLICATION: FeNO is not a valuable tool for the detection of asthma in the community as it is confounded by other atopic conditions. 相似文献
