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Original Research: PULMONARY PHYSIOLOGY |

Maximal Flow at Functional Residual Capacity in Healthy Children From Birth to 7 Years, and Beyond

Daphna Vilozni, PhD; Lea Bentur, MD; Simon Godfrey, MD; Michael Barker, MD; Ephraim Bar-Yishay, PhD
Author and Funding Information

From the Pediatric Pulmonary Unit (Dr Vilozni), The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, Ramat-Gan, Israel; the Sackler Faculty of Medicine (Dr Vilozni), Tel-Aviv University, Tel-Aviv, Israel; the Pediatric Pulmonary Unit (Dr Bentur), Meyer Children’s Hospital, Rambam Medical Center, Haifa, Israel; The Institute of Pulmonology (Drs Godfrey and Bar-Yishay), Hadassah University Hospital, Jerusalem, Israel; The Cykiert Pulmonary Function Laboratory (Dr Bar-Yishay), Pediatric Pulmonary Institute, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel; and HELIOS Kinderklinik und Klinik für Pädiatrie m.S. Pneumologie/Immunologie Charité (Dr Barker), Campus Benjamin Franklin, Berlin, Germany.

Correspondence to: Ephraim Bar-Yishay, PhD, The Cykiert Pulmonary Function Laboratory, Pediatric Pulmonary Institute, Schneider Children’s Medical Center of Israel, PO Box 47, Petach-Tikva 49202, Israel; e-mail: ephraimby@gmail.com; ephraimb@clalit.org.il


Funding/Support: The study was funded by the Israeli Lung Association, Tel-Aviv, Israel.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(6):1439-1444. doi:10.1378/chest.10-0625
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Background:  Reference values for maximal expiratory flows throughout childhood have been developed for each age group, but it remains a challenge to find a single outcome measure that can be tracked from birth to childhood. We believe that maximal flow at functional residual capacity (FRC) (V˙ maxFRC) may be a good candidate. The aim of this article was to explore the possible use of V˙ maxFRC as a continuous measure in healthy infants and children of preschool age.

Methods:  Original spirometric data from healthy infants and preschool children in previously published studies from four centers around the world were reanalyzed (N = 242; ages 0-7 years). In preschool children, V˙ maxFRC was extracted by reanalysis of available records. Multiple regression analysis was applied to find the best correlation between V˙ maxFRC and height, weight, and/or age. V˙ maxFRC values were also compared with previously published data from healthy populations of similar ages.

Results:  V˙ maxFRC highly correlated with height from infancy to childhood: Ln{V˙ maxFRC [L/s]} = −11.99 + (2.561 × Ln{Length[cm]}), where Ln is natural logarithm; r = 0.90; SE = 0.355; P < .0001. Adding weight but not age improved the correlation slightly (r = 0.91). V˙ maxFRC values were not affected by sex, maneuver modality (passive or voluntary), body posture, or degree of sedation. We found very good agreement between our calculated V˙ maxFRC values and the extrapolated V˙ maxFRC values from reference data of similar and older populations.

Conclusions:  V˙ maxFRC can be easily extracted from spirometry and can potentially serve as a continuous spirometric parameter for describing maximal flow at low lung volumes. Further studies are needed to confirm V˙ maxFRC values in a wider age range in health and disease.

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