Journal List > Allergy Asthma Respir Dis > v.2(1) > 1059044

Jee, Shin, and Han: Evaluation of lung function in children

Abstract

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea.

References

1. Reddel HK, Taylor DR, Bateman ED, Boulet LP, Boushey HA, Busse WW, et al. An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am J Respir Crit Care Med. 2009; 180:59–99.
crossref
2. Kanner RE, Schenker MB, Munoz A, Speizer FE. Spirometry in children: methodology for obtaining optimal results for clinical and epidemiologic studies. Am Rev Respir Dis. 1983; 127:720–724.
3. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005; 26:948–968.
crossref
4. Beydon N, Davis SD, Lombardi E, Allen JL, Arets HG, Aurora P, et al. An official American Thoracic Society/European Respiratory Society statement: pulmonary function testing in preschool children. Am J Respir Crit Care Med. 2007; 175:1304–1345.
crossref
5. Escobar H, Carver TW Jr. Pulmonary function testing in young children. Curr Allergy Asthma Rep. 2011; 11:473–481.
crossref
6. Tse SM, Gold DR, Sordillo JE, Hoffman EB, Gillman MW, Rifas-Shiman SL, et al. Diagnostic accuracy of the bronchodilator response in children. J Allergy Clin Immunol. 2013; 132:554.e5–559.e5.
crossref
7. Gangell CL, Hall GL, Stick SM, Sly PD. AREST CF. Lung function testing in preschool-aged children with cystic fibrosis in the clinical setting. Pediatr Pulmonol. 2010; 45:419–433.
crossref
8. Mehta S. Neuromuscular disease causing acute respiratory failure. Respir Care. 2006; 51:1016–1021.
9. Seo HK, Chang SJ, Jung DW, Wee YS, Jee HM, Seo JY, et al. The quality control and acceptability of spirometry in preschool children. Korean J Pediatr. 2009; 52:1267–1272.
crossref
10. Pike KC, Rose-Zerilli MJ, Osvald EC, Inskip HM, Godfrey KM, Crozier SR, et al. The relationship between infant lung function and the risk of wheeze in the preschool years. Pediatr Pulmonol. 2011; 46:75–82.
crossref
11. Lum S, Huulskamp G, Merkus P, Baraldi E, Hofhuis W, Stocks J. Lung function tests in neonates and infants with chronic lung disease: forced expiratory maneuvers. Pediatr Pulmonol. 2006; 41:199–214.
crossref
12. Park JH, Yoon JW, Shin YH, Jee HM, Wee YS, Chang SJ, et al. Reference values for respiratory system impedance using impulse oscillometry in healthy preschool children. Korean J Pediatr. 2011; 54:64–68.
crossref
13. Shi Y, Aledia AS, Galant SP, George SC. Peripheral airway impairment measured by oscillometry predicts loss of asthma control in children. J Allergy Clin Immunol. 2013; 131:718–723.
crossref
14. Shin YH, Yoon JW, Choi SH, Baek JH, Kim HY, Jee HM, et al. Use of impulse oscillometry system in assessment of asthma severity for preschool children. J Asthma. 2013; 50:198–203.
crossref
15. Shin YH, Jang SJ, Yoon JW, Jee HM, Choi SH, Yum HY, et al. Oscillometric and spirometric bronchodilator response in preschool children with and without asthma. Can Respir J. 2012; 19:273–277.
crossref
16. Jee HM, Kwak JH, Jung da W, Han MY. Useful parameters of bronchial hyperresponsiveness measured with an impulse oscillation technique in preschool children. J Asthma. 2010; 47:227–232.
crossref
17. Kirkby J, Stanojevic S, Welsh L, Lum S, Badier M, Beardsmore C, et al. Reference equations for specific airway resistance in children: the Asthma UK initiative. Eur Respir J. 2010; 36:622–629.
crossref
18. Son BK, Lim DH, Kim JH, Choi JW, Kim SK, Chung SW. Normal predicted value of airway resistance by flow interrupter technique in Korean primary school-aged children. J Korean Pediatr Soc. 1996; 39:1095–1102.
19. Subbarao P, Stanojevic S, Brown M, Jensen R, Rosenfeld M, Davis S, et al. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis: a pilot study using inhaled hypertonic saline. Am J Respir Crit Care Med. 2013; 188:456–460.
crossref
20. Rosenfeld M, Allen J, Arets BH, Aurora P, Beydon N, Calogero C, et al. An official American Thoracic Society workshop report: optimal lung function tests for monitoring cystic fibrosis, bronchopulmonary dysplasia, and recurrent wheezing in children less than 6 years of age. Ann Am Thorac Soc. 2013; 10:S1–S11.
crossref
21. Kim KW, Choi BS, Lee YJ, Eun HS, Sohn MH, Park KI, et al. Utility of infant pulmonary function test in bronchopulmonary dysplasia. Pediatr Allergy Respir Dis. 2010; 20:68–75.
22. Wanger J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F, et al. Standardisation of the measurement of lung volumes. Eur Respir J. 2005; 26:511–522.
crossref
23. Bisgaard H, Nielsen KG. Plethysmographic measurements of specific airway resistance in young children. Chest. 2005; 128:355–362.
crossref
24. Nielsen KG, Bisgaard H. Discriminative capacity of bronchodilator response measured with three different lung function techniques in asthmatic and healthy children aged 2 to 5 years. Am J Respir Crit Care Med. 2001; 164:554–559.
crossref
25. van der Ent CK, Brackel HJ, van der Laag J, Bogaard JM. Tidal breathing analysis as a measure of airway obstruction in children three years of age and older. Am J Respir Crit Care Med. 1996; 153(4 Pt 1):1253–1258.
crossref
26. Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med. 2000; 161:309–329.
27. Cockcroft DW. Direct challenge tests: Airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest. 2010; 138:2 Suppl. 18S–24S.
TOOLS
Similar articles