Respiratory Medicine
Volume 105, Issue 1 , Pages 15-23, January 2011

Reference values for paediatric pulmonary function testing: The Utrecht dataset

  • Marije Koopman

      Affiliations

    • Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Huispostnr KH 01.419.0, P.O. Box 85090, 3508 GA Utrecht, The Netherlands
    • Corresponding Author InformationCorresponding author. Wilhelmina Children’s Hospital, University Medical Center Utrecht, Department of Paediatric Pulmonology, Huispostnummer KH.01.419.0, P O Box 85090, 3508 AB Utrecht, The Netherlands. Tel.: +31 88 7553201; fax: +31 88 7554747.
    • ,
  • Pieter Zanen

      Affiliations

    • Division of Heart and Lungs, University Medical Centre Utrecht, Huispostnr F 02.333, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
    • ,
  • Cas L.J.J. Kruitwagen

      Affiliations

    • Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Huispost Str. 6.131, P.O. Box 85060, 3508 GA Utrecht, The Netherlands
    • ,
  • Cornelis K. van der Ent

      Affiliations

    • Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Huispostnr KH 01.419.0, P.O. Box 85090, 3508 GA Utrecht, The Netherlands
    • ,
  • Hubertus G.M. Arets

      Affiliations

    • Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Centre Utrecht, Huispostnr KH 01.419.0, P.O. Box 85090, 3508 GA Utrecht, The Netherlands

Received 24 March 2010; accepted 27 July 2010. published online 04 October 2010.

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.

Keywords: Bodyplethysmography, Diffusion capacity, Interrupter resistance, Reference data, Spirometry

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PII: S0954-6111(10)00341-0

doi:10.1016/j.rmed.2010.07.020

Respiratory Medicine
Volume 105, Issue 1 , Pages 15-23, January 2011

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