Spirometry in early childhood in cystic fibrosis patients

Daphna Vilozni, Lea Bentur, Ori Efrati, Tal Minuskin, Asher Barak, Amir Szeinberg, Hannah Blau, Elie Picard, Eitan Kerem, Yaacov Yahav, Arie Augarten

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Spirometry data in cystic fibrosis (CF) patients in early childhood is scarce, and the ability of spirometry to detect airways obstruction is debatable. Objective: To evaluate the ability of spirometry to detect airflow obstruction in CF patients in early childhood. Methods: CF children (age range, 2.5 to 6.9 years) in stable clinical condition were recruited from five CF centers. The children performed guided spirometry (SpiroGame; patented by Dr. Vilzone, 2003). Spirometry indices were compared to values of a healthy early childhood population, and were analyzed with relation to age, gender, and conical parameters (genotype, pancreatic status, and presence of Pseudomonas in sputum or oropharyngeal cultures). Results: Seventy-six of 93 children tested performed acceptable spirometry. FVC, FEV1, forced expiratory flow in 0.5 s (FEV0.5), and forced expiratory flow at 50% of vital capacity (FEF50) were significantly lower than healthy (z scores, mean ± SD: -0.36 ± 0.58, -0.36 ± 0.72, -1.20 ± 0.87; and -1.80 ± 1.47, respectively; p < 0.01); z scores for FEV1 and FVC were similar over the age ranges studied. However, z scores for FEV 0.5 and forced expiratory flow at 25 to 75% of vital capacity were significantly lower in older children compared to younger children (p < 0.001), and a higher proportion of 6-year-old than 3-year-old children had z scores that were > 2 SDs below the mean (65% vs 5%, p < 0.03). Girls demonstrated lower FEF50 than boys (z scores: -2.42 ± 1.91 vs -1.56 ± 1.23; p < 0.001). Clinical parameters evaluated were not found to influence spirometric indices. Conclusions: Spirometry elicited by CF patients in early childhood can serve as an important noninvasive tool for monitoring pulmonary status. FEV0.5 and flow-related volumes might be more sensitive than the traditional FEV1 in detecting and portraying changes in lung function during early childhood.

Original languageEnglish
Pages (from-to)356-361
Number of pages6
JournalChest
Volume131
Issue number2
DOIs
StatePublished - Feb 2007
Externally publishedYes

Keywords

  • Airflow obstruction
  • Cystic fibrosis
  • Early childhood
  • Prognosis
  • Pulmonary infection
  • Spirometry

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