Reference values for paediatric pulmonary function testing: The Utrecht dataset

• Published in: Respiratory medicine Vol. 105; no. 1; pp. 15 - 23
• Main Authors: Koopman, Marije, Zanen, Pieter, Kruitwagen, Cas L.J.J, van der Ent, Cornelis K, Arets, Hubertus G.M
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.01.2011; Elsevier; Elsevier Limited
• Subjects: Adolescent; Anthropometry; Biological and medical sciences; Bodyplethysmography; Child; Child, Preschool; Data Interpretation, Statistical; Diffusion capacity; European Continental Ancestry Group; Female; Humans; Interrupter resistance; Lung Diseases - diagnosis; Lung Diseases - physiopathology; Male; Medical sciences; Pneumology; Pulmonary Diffusing Capacity - physiology; Pulmonary/Respiratory; Reference data; Reference Values; Respiratory Function Tests - methods; Respiratory Function Tests - standards; Spirometry; Bodyplethysmography; Interrupter resistance; Spirometry; Diffusion capacity; Reference data; Lung function; Capacity; Exploration; Diffusion; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2010.07.020

Summary Background Since populations evolve, measurement protocols and equipment improve and analysis techniques progress, there is an ongoing need to reassess reference data for pulmonary function tests. Furthermore, reference values for total lung capacity and carbon monoxide diffusion capacity are scarcely available in children. We aimed to provide updated reference equations for most commonly used pulmonary function indices in Caucasian children. Methods In the ‘Utrecht Pulmonary Function Reference Data Study’ we collected data in Caucasian children aged 2–18 years. We analyzed them using the ‘Generalized Additive Models for Location Scale and Shape’ (GAMLSS) statistical method. Results Measurements of interrupter resistance (Rint ) ( n  = 877), spirometry ( n  = 1042), body plethysmography ( n  = 723) and carbon monoxide diffusion/helium dilution ( n  = 543) were obtained in healthy children. Height (or the natural logarithm of height) and age (or the natural logarithm of age) were both significantly related to most outcome measures. Also sex was a significant determinant, except for RV, RV/TLC, FRCpleth , Raw0,5 , Rawtot , Rint and FEF values. The application of previously published reference equations on the study population resulted in misinterpretation of pulmonary function. Conclusion These new paediatric reference equations provide accurate estimates of the range of normality for most commonly used pulmonary function indices, resulting in less underdiagnosis and overdiagnosis of pulmonary diseases.