Efeito da terminação precoce da expiração nos parâmetros espirométricos em crianças pré-escolares saudáveis

Abstract

Objective: To evaluate the acceptability and reproducibility of spirometry in preschool children; to estimate the effect size of early termination of exhalation (ETE) on FVC, FEV 1 and FEV 0.5 ; and to evaluate the validity of FEV 0.5 in curves with ETE. Methods: Spirometric data were obtained from 240 healthy preschool children, who were selected by simple sampling. On the basis of the best curve from each child according to the end of exhalation, three groups were formed: no ETE (nETE); ETE and flow ≤ 10% of the highest PEF (ETE≤10); and ETE and flow > 10% of the highest PEF value (ETE>10). The reproducibility of FVC, FEV 1 and FEV 0.5 was compared among the three groups. The effect of ETE on FVC, FEV 1 , and FEV 0.5 was assessed. Results: Of the 240 children tested, 112 (46.5%)-82 (34.0%) of those in the nETE group and 30 (12.5%) of those in the ETE≤10 group-had acceptable curves for all the parameters. In 64 (27.0%) of those in the ETE>10 group, the curves were acceptable only for FEV 0.5 , increasing the proportion of children with valid FEV 0.5 to 73.0%. There were no significant differences between the nETE and ETE≤10 groups in terms of the mean values of the parameters assessed. Conclusions: Maneuvers with ETE and flow ≤ 10% of the highest PEF are valid. In individuals with a flow > 10% of the highest PEF value, these maneuvers are only valid for FEV 0.5 .Keywords: Spirometry; Child, preschool; Vital capacity; Forced expiratory volume; Reproducibility of results. ResumoObjetivo: Avaliar a aceitabilidade e a reprodutibilidade da espirometria em pré-escolares; estimar o tamanho do efeito da terminação precoce da expiração (TPE) nos valores de CVF, VEF 1 e VEF 0,5 ; e avaliar a validade do VEF 0,5 em curvas com TPE. Métodos: Espirometrias foram obtidas em 240 pré-escolares saudáveis, selecionados por amostragem simples. Três grupos foram formados com base na melhor curva de cada criança de acordo com o término da expiração: sem TPE (sTPE); com TPE e fluxo ≤ 10% do maior PFE (TPE≤10); e com TPE e fluxo > 10% do maior PFE (TPE>10). Foram comparadas a reprodutibilidade da CVF, VEF 1 e VEF 0,5 nos três grupos. Foi avaliado o efeito da TPE em CVF, VEF 1 e VEF 0,5 . Resultados: Das 240 crianças testadas, 112 (46.5%) realizaram curvas aceitáveis para todos os parâmetros -82 (34,0%) no grupo sTPE e 30 (12,5%) no grupo TPE≤10. Em 64 (27,0%) no grupo TPE>10, as curvas foram aceitáveis apenas para VEF 0,5 , aumentando para 73,0% a proporção de crianças com VEF 0,5 válido. Não houve diferenças significantes nas médias dos parâmetros avaliados entre os grupos sTPE e TPE≤10. Conclusões: Manobras com TPE e fluxo ≤ 10% do maior PFE são válidas. Em indivíduos com fluxo > 10% do maior PFE, essas manobras são válidas somente para VEF 0,5 .

Bronchodilator response cut-off points and FEV 0.75 reference values for spirometry in preschoolers

“…Given that spirometry is a low-cost and noninvasive test, and given that several studies 7 , 8 , 10 , 12 - 14 have demonstrated that preschool children can perform acceptable and reproducible FEV 0.5 and FEV 0.75 measurements, there is a need to determine bronchodilator response cut-off points for children in this age group so that spirometry can be used in daily clinical practice. Only two studies 18 , 19 have assessed bronchodilator response using spirometry exclusively in preschool children.…”

Malay Version of the ATS-DLD-78A Questionnaire for Detecting Respiratory Symptoms in Welders: Translation and Cross-Cultural Validation.

“…Several studies have shown that ATS-DLD-78 can be utilised in multicultural settings in the translated questionnaire, with validation studies of the translated Sindhi, Portuguese, Urdu, French, Chinese, Norwegian, Thai, Hausa, Japanese, and Zulu versions showing considerable consistency across cultures [17][18][19][20][21][22][23][24][25][26][27] . As a result, the American Thoracic Society Division of Lung Disease questionnaire (ATS-DLD-78A) is an established method for evaluating and detecting respiratory system warning indicators in the investigated population globally.…”