Viabilidade da realização de espirometria em pré-escolares

Abstract

Objective: To determine the rate at which satisfactory spirometry results are obtained (spirometry success rate) in preschool children. Methods: We analyzed the spirometry results of children ≤ 6 years of age. All tests were conducted between June of 2009 and February of 2010 in the Pulmonary Function Laboratory of the Hospital Infantil Jeser Amarante Faria, located in the city of Joinville, Brazil. The spirometry program employed features an animated incentive (soap bubbles). The procedures were performed by a pediatric pulmonologist, in accordance with the reproducibility and acceptability criteria recommended by the American Thoracic Society. We attempted to achieve an expiratory time of at least 1 s. The following parameters were measured: FVC, FEV 0.5 , FEV 1 , and the FEV 1 /FVC ratio. Results: Our sample comprised 74 children. The spirometry success rate was 82%. Although the performance improved with age, the difference between younger and older children was not significant (p > 0.05). An average of 6.6 attempts/test were needed in order to achieve acceptable, reproducible curves. All 61 successful tests produced satisfactory FEV 0.5 and FEV 1 values. By calculating Z scores, we found that 21.6% of the children presented with an obstructive pattern. Conclusions: In our sample, the spirometry success rate was high, showing that spirometry is a valid method for assessing pulmonary function in preschool children. The high success rate in our sample might be attributable to the use of an incentive and to the fact that the tests were performed by professionals specializing in pediatrics.

Functional Respiratory Study in Preschool Children: A Review

“…1 Pulmonary function tests (PFT) quantify objectively the lung commitment and are very useful in the diagnosis, therapeutic monitoring and prognostic evaluation of several pathologies as well as in the risk/benefit assessment of specific clinical interventions. [2][3][4][5][6] These methods have been very useful for the pathophysiological understanding of cystic fibrosis, primary ciliary dyskinesia, recurrent wheezing and bronchial asthma. 1,7,8 The last one is one of the most common problems for public health, with an increase in its incidence at early ages, affecting about 5-10% of children in industrialized countries.…”

“…1,9 In general, these represent a clinical parameter as well as an instrument for measuring growth and lung development. 3 However, preschool children have difficulties to execute some maneuvers, since they require a degree of coordination and cooperation. They have short time attention, low frustration tolerance and physiological limitations leading to the necessity to establish specific guidelines for this age group, as well as special attention from health professionals.…”

“…They have short time attention, low frustration tolerance and physiological limitations leading to the necessity to establish specific guidelines for this age group, as well as special attention from health professionals. 2,3,[10][11][12][13][14] Children must feel comfortable and for that reason, health professionals should establish a friendly conversation or use distraction techniques, such as videos, music, books or games incentives linked to the pulmonary function equipment. 10,[14][15][16] The American Thoracic Society (ATS) and the European Respiratory Society (ERS) published in 2007 recommendations for the criteria for acceptability and reproducibility for preschool children, reference values being currently available for spirometry and specific airway resistance (sRaw).…”

“…3,10,14,17 An ideal PFT is applicable at any age so that longitudinal studies can be made, monitoring the child from his childhood through his adult age. They are simple to perform, safe, reproducible and sensitive enough to distinguish health from disease.…”

“…2 In Veras TN et al 3 study, the success rate of spirometry in patients in preschool-age was 82%, 3 Santos N et al,…”