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Original Research: LUNG FUNCTION |

Accuracy of Whole-Body Plethysmography Requires Biological Calibration

Porntiva Poorisrisak, MD; Carsten Vrang, MD; Jorn Molgaard Henriksen, DMSci; Bent Klug, DMSci; Birgitte Hanel, DMSci; Hans Bisgaard, DMSci
Author and Funding Information

*From the Pediatric Department (Drs. Poorisrisak and Vrang), Naestved Hospital, Naestved, Denmark; the Pediatric Department (Dr. Henriksen), Aarhus University Hospital, Skejby, Denmark; the Pediatric Department (Dr. Klug), Copenhagen University Hospital, Hvidovre, Denmark; the Pediatric Department (Dr. Hanel), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; and the Copenhagen Prospective Study on Asthma in Children (Dr. Bisgaard), Danish Pediatric Asthma Center, Health Sciences, University of Copenhagen, Copenhagen University Hospital, Gentofte, Denmark.

Correspondence to: Hans Bisgaard, DMSci, Copenhagen Prospective Study on Asthma in Children, Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Ledreborg Alle 34, DK 2820 Gentofte, Denmark; e-mail: Bisgaard@copsac.dk


The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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

For editorial comment see page 1412


© 2009 American College of Chest Physicians


Chest. 2009;135(6):1476-1480. doi:10.1378/chest.08-1555
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Background:  Specific airway resistance (sRaw) measured by whole-body plethysmography in young children is increasingly used in research and clinical practice. The method is precise and feasible. However, there is no available method for calibration of the resistance measure, which raises concern of accuracy. Our aim was to determine the agreement of sRaw measurements in six centers and expand normative sRaw values for nonasthmatic children including these centers.

Method:  Identical hardware with different software versions was used at the six centers. Measurements followed a standard operating procedure: (1) seven healthy young children were brought to each of the six centers for sRaw measurements; and (2) 105 healthy preschool children (52 boys; mean age, 5.1 years; interquartile range, 4.3 to 6.0) were recruited locally for sRaw measurements.

Results:  (1) The sRaw of the seven-children study group was significantly lower at two centers compared with the other four centers, and one center had significantly higher sRaw than all the other centers (p < 0.05). Error in the factory settings of the software was subsequently discovered in one of the deviating centers. (2) Normative data (105 preschool children) were generated and were without significant difference between centers and independent of height, weight, age, and gender. We subsequently pooled these normative data (105 children) with our previous data from 121 healthy young children (overall mean sRaw, 1.27; SD, 0.25).

Conclusion:  Control using biological standards revealed errors in the factory setting and highlights the need for developing methods for verification of resistance measures to assure accuracy. Normative data were subsequently generated. Importantly, other centers using such normative data should first consider proper calibration before applying reference values.

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