The reliability of spirometry is dependent on strict quality control. We examined whether quality control criteria recommended for adults could be applied to children aged 2-5 years. Forty-two children with cystic fibrosis and 37 healthy children attempted spirometry during their first visit to our laboratory. Whereas 59 children (75%) were able to produce a technically satisfactory forced expiration lasting 0.5 second, only 46 (58%) could produce an expiration lasting 1 second, with the youngest children having the most difficulty. Start of test criteria for adults were inappropriate for this age group, with only 16 of 59 children producing a volume of back extrapolation as a proportion of forced vital capacity of less than 5%, whereas all but 4 could produce a volume of back extrapolation of 80 ml or less. More than 90% of children were able to produce a second forced vital capacity and a second forced expired volume in 0.75 second within 10% of their highest. Errors in the spirometry software resulted in inaccurate reporting of expiratory duration and inappropriate timed expired volumes in some children. We describe recommendations for modified start of test and repeatability criteria for this age group, and for improvements in software to facilitate better quality control.

译文

肺活量测定的可靠性取决于严格的质量控制。我们检查了是否可以将成人推荐的质量控制标准应用于2-5岁的儿童。42名患有囊性纤维化的儿童和37名健康儿童在首次访问我们的实验室时尝试进行肺活量测定。尽管59名儿童 (75% 名) 能够产生技术上令人满意的持续0.5秒的强制呼气,但只有46名儿童 (58% 名) 能够产生持续1秒的呼气,其中最小的儿童最困难。成人的开始测试标准不适合该年龄组,59名儿童中只有16名产生的背部外推量与强迫肺活量的比例小于5%,而4名儿童以外的所有儿童都可以产生80毫升或更少的背部外推量。超过90% 的儿童能够在0.75秒内产生第二次强制肺活量和第二次强制过期量,在其最高10% 范围内。肺活量测定软件中的错误导致某些儿童的呼气持续时间报告不准确,并且定时过期量不适当。我们描述了针对该年龄段的修改测试开始和可重复性标准的建议,以及对软件进行改进以促进更好的质量控制的建议。

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