Determination of maximal voluntary ventilation in children with cystic fibrosis.
Maximal voluntary ventilation (MVV) may be determined directly by the sprint method or calculated from pulmonary function data, using the functions MVV = forced expired volume in 1 sec (FEV(1)) x 35 or MVV = FEV(1) x 40. The purpose of this paper was to test the validity of the equation over a wide range of lung function in children. Cystic fibrosis (CF), a chronic lung disease where children typically have a wide range of pulmonary function, was chosen as the study requirement. Spirometric data from 332 children with CF who underwent pulmonary function testing between 1987-2000 were stratified according to disease severity, and box-plots comparing the ratio of MVV to FEV(1) for each category were generated. As results indicated that the equation underestimates true MVV proportionally to the degree of airflow limitation, a new function to predict MVV for this population was derived and tested. The new equation was derived using data from patients who were tested on odd-numbered days (group A). The validity of the new equation was then tested on the patients tested on even-numbered days (group B). To test its validity, the results were compared to the "gold standard" sprint values using a Bland and Altman plot. MVV was expressed as a function of FEV(1) and predicted FEV(1): MVV = 27.7(FEV(1)) + 8.8(PredFEV(1)) (R(2) = 0.98, P < 0.05). In this way, the accuracy of the new equation was confirmed. Whenever possible, we recommend MVV be determined by the sprint method in accordance with ATS guidelines. If this is not feasible, we recommend considering the new prediction equation.
Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
Richard
R
Stein
Hiran
H
Selvadurai
Allan
A
Coates
Donna L
DL
Wilkes
Jane
J
Schneiderman-Walker
Mary
M
Corey
D000293:Adolescent; D002648:Child; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005080:Exercise Test; D017079:Exercise Tolerance; D006801:Humans; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D012189:Retrospective Studies; D013147:Spirometry