title: Spirometry in early childhood in cystic fibrosis patients.
abstract: BACKGROUND
  Spirometry data in cystic fibrosis (CF) patients in early childhood is scarce, and the ability of spirometry to detect airways obstruction is debatable.
  
  
  OBJECTIVE
  To evaluate the ability of spirometry to detect airflow obstruction in CF patients in early childhood.
  
  
  METHODS
  CF children (age range, 2.5 to 6.9 years) in stable clinical condition were recruited from five CF centers. The children performed guided spirometry (SpiroGame; patented by Dr. Vilzone, 2003). Spirometry indices were compared to values of a healthy early childhood population, and were analyzed with relation to age, gender, and clinical parameters (genotype, pancreatic status, and presence of Pseudomonas in sputum or oropharyngeal cultures).
  
  
  RESULTS
  Seventy-six of 93 children tested performed acceptable spirometry. FVC, FEV1, forced expiratory flow in 0.5 s (FEV0.5), and forced expiratory flow at 50% of vital capacity (FEF50) were significantly lower than healthy (z scores, mean +/- SD: - 0.36 +/- 0.58, - 0.36 +/- 0.72, - 1.20 +/- 0.87; and - 1.80 +/- 1.47, respectively; p < 0.01); z scores for FEV1 and FVC were similar over the age ranges studied. However, z scores for FEV0.5 and forced expiratory flow at 25 to 75% of vital capacity were significantly lower in older children compared to younger children (p < 0.001), and a higher proportion of 6-year-old than 3-year-old children had z scores that were > 2 SDs below the mean (65% vs 5%, p < 0.03). Girls demonstrated lower FEF50 than boys (z scores: - 2.42 +/- 1.91 vs - 1.56 +/- 1.23; p < 0.001). Clinical parameters evaluated were not found to influence spirometric indices.
  
  
  CONCLUSIONS
  Spirometry elicited by CF patients in early childhood can serve as an important noninvasive tool for monitoring pulmonary status. FEV0.5 and flow-related volumes might be more sensitive than the traditional FEV1 in detecting and portraying changes in lung function during early childhood.
authors.affiliation: Pediatric Pulmonary Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel HaShomer, Ramat-Gan, Israel, 52621. avi_vil@bezeqint.net
authors.forename: Daphna
authors.initials: D
authors.lastname: Vilozni
authors.forename: Lea
authors.initials: L
authors.lastname: Bentur
authors.forename: Ori
authors.initials: O
authors.lastname: Efrati
authors.forename: Tal
authors.initials: T
authors.lastname: Minuskin
authors.forename: Asher
authors.initials: A
authors.lastname: Barak
authors.forename: Amir
authors.initials: A
authors.lastname: Szeinberg
authors.forename: Hannah
authors.initials: H
authors.lastname: Blau
authors.forename: Elie
authors.initials: E
authors.lastname: Picard
authors.forename: Eitan
authors.initials: E
authors.lastname: Kerem
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Yahav
authors.forename: Arie
authors.initials: A
authors.lastname: Augarten
mesh_terms: D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology