Prevalence, stability, and clinical significance of an isolated low FEV 1 spirometry pattern in children.

Autor: Wyatt ML; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.; Department of Pediatrics, University of Washington, Seattle, Washington, USA., Sokolow AG; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Brown RF; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Kaslow JA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Tolle JJ; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Weiner DJ; Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Rosas-Salazar C; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2024 Jun; Vol. 59 (6), pp. 1747-1756. Date of Electronic Publication: 2024 Apr 01.
DOI: 10.1002/ppul.26987
Abstrakt: Objectives: In adults, an isolated low FEV 1 pattern (an FEV 1 below the lower limit of normal with a preserved FVC and FEV 1 /FVC) has been associated with the risk of developing airway obstruction. Our objective was to examine the prevalence, stability, and clinical significance of an isolated low FEV 1 pattern in the pediatric population.
Methods: We conducted a retrospective study of spirometries from children ages 6-21 years and categorized tests into spirometry patterns according to published guidelines and recent literature. In a subgroup of tests with an isolated low FEV 1 pattern, we evaluated spirometry technique. We also examined the association of having a test with an isolated low FEV 1 pattern with clinical markers of disease severity in a subgroup of children with cystic fibrosis (CF).
Results: The isolated low FEV 1 pattern was uncommon across the 29,979 tests included (n = 645 [2%]). In the 263 children with an isolated low FEV 1 pattern who had a follow-up test performed, the most frequent spirometry pattern at last test was normal (n = 123 [47%]). A primary diagnosis of CF was associated with increased odds of having at least one test with an isolated low FEV 1 pattern (OR = 8.37, 95% CI = 4.70-15.96, p < .001). The spirometry quality in a subgroup of tests with an isolated low FEV 1 pattern (n = 50) was satisfactory. In the subgroup of children with CF (n = 102), those who had a test with an isolated low FEV 1 pattern had higher odds of using oral antibiotics in the last 12 months than those who had a normal pattern (OR = 3.50, 95% CI = 1.15-10.63, p = .03).
Conclusions: The isolated low FEV 1 pattern can occur repeatedly over time, usually transitions to a normal pattern, is not due to a poor spirometry technique, and could be clinically relevant in children with chronic lung diseases.
(© 2024 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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