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Clinical Investigations: PULMONARY FUNCTION |

Spirometric Reference Values for the 6-s FVC Maneuver*

John L. Hankinson; Robert O. Crapo; Robert L. Jensen
Author and Funding Information

*From Hankinson Consulting (Dr. Hankinson), Valdosta, GA; and Pulmonary Divisions (Drs. Crapo and Jensen), University of Utah and LDS Hospital, Salt Lake City, UT.

Correspondence to: John L. Hankinson, PhD, PO Box 3905, Valdosta, GA 31604-3905; e-mail: hankinson@bellsouth.net



Chest. 2003;124(5):1805-1811. doi:10.1378/chest.124.5.1805
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Study objectives: The guidelines of the National Lung Health Education Program for COPD screening proposed a shorter FVC maneuver (forced expiratory volume at 6 s of exhalation [FEV6]). Although reference values for FEV6 are available from the third National Health and Nutrition Examination Survey, forced expiratory flow between 25% and 75% of FVC (FEF25–75%) reference values for the shorter 6-s maneuver are not available and are needed. In particular, calculation of largest observed volume during the first 6 s of an FVC maneuver (FVC6), from a shortened FVC maneuver, is necessary because the FEF25–75% measurement is based on a percentage of FVC or, for a shorter maneuver, FVC6.

Design: We reanalyzed the raw volume-time curves from the third National Health and Nutrition Examination Survey to calculate FVC6, forced expiratory volume at 0.5 s of exhalation, forced expiratory volume at 3 s of exhalation, ratio of the FEV1 to largest observed volume during the first 6 s of an FVC maneuver expressed as a percentage (FEV1/FEV6%), and forced expiratory flow between 25% and 75% of the largest observed volume during the first 6 s of an FVC maneuver (FEF25–75%6) in addition to the previously reported values for FEV1, FEV6, and FEV1/FEV6%.

Patients or participants: Using the same normal, asymptomatic, nonsmoking reference population from a previous study, reference values for these parameters were derived from best values.

Results: A total of 2,261 white, 2,564 African-American, and 2,666 Mexican-American subjects aged 8 to 80 years were included in the analysis. Fifty-four subjects from the previous study were not included due to missing raw volume-time curves.

Conclusions: These reference values, utilizing the FVC6, provide investigators with the means of evaluating the relative merits of using the shorter FVC maneuver as a surrogate for the traditional FVC. They are needed particularly for calculating FEF25–75%, as statistically significant differences were observed between the FEF25–75% and FEF25–75%6.

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