Allergy Asthma Respir Dis.  2014 Jul;2(3):187-193. 10.4168/aard.2014.2.3.187.

Predicted normal values of pulmonary function tests in normal Korean children

• Park CH
• Kim HB
• Jung YH
• Lee E
• Yang SI
• Seo JH
• Kwon JW
• Kim HY
• Kim BJ
• Lee SY
• Song DJ
• Jang GC
• Kim WK
• Shim JY
• Hong SJ

• KMID: 2262518
• DOI: http://doi.org/10.4168/aard.2014.2.3.187

Abstract

PURPOSE
Pulmonary function tests are useful and important methods for evaluating patients with respiratory diseases. To assess lung function, we need to establish normal values of lung function, which vary according to population, age, gender and growth, particularly in children. This study was undertaken to establish normal predicted values of pulmonary function tests and to predict renewed reference values by spirometry in Korean school children.
METHODS
Spirometric forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory flow at 25% to 75% of FVC (FEF25%-75%), and peak expiratory flow rate (PEFR) were measured in 406 healthy elementary school children (age, 6-12 years old) in May, 2012. Multiple linear regression analysis was performed for each spirometric parameter against age, height, weight and body surface area (BSA) separately for boys and girls, and derived reference equations and coefficients for all the spirometric parameters.
RESULTS
All the measured spirometric parameters were significantly correlated with age, height, weight, and BSA. FVC was higher in boys aged 6-10 years than girls at ages matched. Height showed the highest correlation coefficient for all the spirometric parameters followed by BSA, weight and age in both genders. The normal predicted values of FVC and FEV1 at 130 cm in this study using renewed reference equations were approximately in the middle compared to previous studies.
CONCLUSION
We reported here the renewed reference equations for normal predicted values of pulmonary function tests with high coefficients of determination based on updated data in healthy Korean children.

Keyword

Reference equation; Spirometry; Reference value; Pulmonary function; Children

MeSH Terms

Body Surface Area
Child*
Female
Forced Expiratory Volume
Humans
Linear Models
Lung
Peak Expiratory Flow Rate
Reference Values*
Respiratory Function Tests*
Spirometry
Vital Capacity

Reference

1. Ruppel GL, Enright PL. Pulmonary function testing. Respir Care. 2012; 57:165–175.

2. 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.

3. Lim DH, Kim JH, Park JH, Choi JW, Kim SK, Son BK. Normal predicted values of pulmonary function test in Korean primary school-aged children. J Korean Pediatr Soc. 1994; 37:240–249.

4. Yoon KA, Lim HS, Koh YY, Kim H. Normal predicted values of pulmonary function test in Korean school-aged children. J Korean Pediatr Soc. 1993; 36:25–37.

5. Cha IA, Kim KS, Kim YW, Kim KB. Normal predicted vlues of pulmonary function test in children. J Korean Pediatr Soc. 1994; 37:672–688.

6. Nam SY, Kim KH, Hong YM, Kim GH. Normal predicted values of pulmonary function test in healthy Korean children. J Korean Pediatr Soc. 1998; 41:338–345.

7. Cho A, Lee KH, Yoon HS. Expected normal values of pulmonary function test in normal children (ages 6 years through 12 years). Allergy. 1992; 12:517–527.

8. Yoon JS, Choi EY, Lee HS, Ahn YM. A study of predicted values of peak expiratory flow rates in primary school children. J Korean Pediatr Soc. 1991; 34:487–496.

9. Yang SY, Na MJ, Choi WH, Kim KW. Expected normal values of pulmonary function test in pediatric age 1. by spirometry. J Korean Pediatr Soc. 1989; 32:206–214.

10. Lim SW, Lee KY. A study on predicted values of peak expiratory flow rate (PEER) in primary school children. J Korean Pediatr Soc. 1986; 29:56–65.

11. Ip MS, Karlberg EM, Karlberg JP, Luk KD, Leong JC. Lung function reference values in Chinese children and adolescents in Hong Kong. I. Spirometric values and comparison with other populations. Am J Respir Crit Care Med. 2000; 162(2 Pt 1):424–429.

12. Nystad W, Samuelsen SO, Nafstad P, Edvardsen E, Stensrud T, Jaakkola JJ. Feasibility of measuring lung function in preschool children. Thorax. 2002; 57:1021–1027.

13. Torres LA, Martinez FE, Manco JC. Correlation between standing height, sitting height, and arm span as an index of pulmonary function in 6-10-year-old children. Pediatr Pulmonol. 2003; 36:202–208.

14. Al-Riyami BM, Al-Rawas OA, Hassan MO. Normal spirometric reference values for Omani children and adolescents. Respirology. 2004; 9:387–391.

15. Jeng MJ, Chang HL, Tsai MC, Tsao PC, Yang CF, Lee YS, et al. Spirometric pulmonary function parameters of healthy Chinese children aged 3-6 years in Taiwan. Pediatr Pulmonol. 2009; 44:676–682.

16. Korea Centers for Disease Control and Prevention, Division of Chronic Disease Surveillance, Committee for the Development of Growth Standard for Korean Children and Adolescents. Korean Pediatric Society, Committee for School Health and Public Health Statistics. 2007 Korean Children and Adolescents Growth Standard (commentary for the development of 2007 growth chart). Cheongwon: Korea Centers for Disease Control and Prevention, Division of Chronic Disease Surveillance;2007.

17. Gehan EA, George SL. Estimation of human body surface area from height and weight. Cancer Chemother Rep. 1970; 54:225–235.

18. Primhak RA, Biggins JD, Tsanakas JN, Hatzimichael A, Milner RD, Karpouzas JG. Factors affecting the peak expiratory flow rate in children. Br J Dis Chest. 1984; 78:26–35.

19. Morse M, Schlutz FW, Cassels DE. The lung volume and its subdivisions in normal boys 10-17 years of age. J Clin Invest. 1952; 31:380–391.

20. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983; 127:725–734.

21. Thurlbeck WM. Postnatal human lung growth. Thorax. 1982; 37:564–571.

22. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis. 1981; 123:659–664.

23. Schoenberg JB, Beck GJ, Bouhuys A. Growth and decay of pulmonary function in healthy blacks and whites. Respir Physiol. 1978; 33:367–393.

24. Peabody FW, Wentworth JA. Clinical studies of the respiration. IV. The vital capacity of the lungs and its relation to dyspnea. Arch Int Med. 1917; 20:443–467.

25. Lundsgaard C, Van Slyke DD. Studies of lung volume. I: relation between thorax size and lung volume in normal adults. J Exp Med. 1918; 27:65–86.

26. Dockery DW, Berkey CS, Ware JH, Speizer FE, Ferris BG Jr. Distribution of forced vital capacity and forced expiratory volume in one second in children 6 to 11 years of age. Am Rev Respir Dis. 1983; 128:405–412.

27. Leeder SR, Swan AV, Peat JK, Woolcook AJ, Blackburn CR. Maximum expiratory flow-volume curves in children: changes with growth and individual variability. Bull Eur Physiopathol Respir. 1977; 13:249–260.

28. Taussig LM, Cota K, Kaltenborn W. Different mechanical properties of the lung in boys and girls. Am Rev Respir Dis. 1981; 123:640–643.

29. Taussig LM. Maximal expiratory flows at functional residual capacity: a test of lung function for young children. Am Rev Respir Dis. 1977; 116:1031–1038.

30. Zapletal A, Jech J, Paul T, Samanek M. Pulmonary function studies in children living in an air-polluted area. Am Rev Respir Dis. 1973; 107:400–409.

31. Tager IB, Weiss ST, Munoz A, Rosner B, Speizer FE. Longitudinal study of the effects of maternal smoking on pulmonary function in children. N Engl J Med. 1983; 309:699–703.