Vilozni Daphna, Efrati Ori, Hakim Fahed, Adler Adi, Livnat Galit, Bentur Lea
Pediatric Pulmonary Unit, Meyer Children's Hospital of Haifa, Rambam Medical Center, Haifa, Israel.
Pediatr Pulmonol. 2009 Sep;44(9):885-91. doi: 10.1002/ppul.21072.
Measurement of FRC in whole body plethysmography (FRCpleth) is not performed in young children (aged 3-5 years) because it involves sitting alone in a closed box and breathing attempts against occlusion.
To assess the feasibility of measuring FRCpleth in young children.
Seventy-one of 102 children (age range 3.3-6.9 years) performed spirometry and FRCpleth measurements. Twenty-six children had controlled asthma (Group-A); 26 children were tested during asthma exacerbation had uncontrolled asthma (Group-UA), and 19 children were tested after receiving chemotherapy treatment (Group-C). Tests according to adult recommendations were first taught outside the plethysmograph and then performed with minor technical adaptations. Each test included two consecutive FRC measurements obtained during 2-3 sec of occlusion. Total lung capacity (TLC) and residual volume (RV) were calculated. Values were compared to FRC measured by Helium-dilution (FRC-He) in healthy preschool children and to extrapolated FRCpleth values of school children, and between the groups.
Group-A showed normal spirometry and normal TLC values, with mildly elevated FRCpleth and RV values (125 +/- 20 and 153 +/- 33 %predicted, respectively; P < 0.0001 for both values). Group-UA showed obstructed flows combined with high FRCpleth and RV (146 +/- 26 and 189 +/- 38 %predicted; P < 0.0001) and normal TLC. Group-C showed a restrictive spirometry pattern combined with lower than normal TLC (86 +/- 15 %predicted; P < 0.0251).
Measuring absolute lung volumes by plethysmography in young children is feasible and can detect abnormal lung volumes. It is essential to study a larger group of healthy children for reference values and to allow for standardization of the procedure.
由于在全身体积描记法（FRCpleth）中测量功能残气量（FRC）需要幼儿（3至5岁）独自坐在一个封闭的箱子里，并在气道阻塞的情况下进行呼吸尝试，因此该方法不适用于幼儿。
评估在幼儿中测量FRCpleth的可行性。
102名儿童（年龄范围3.3至6.9岁）中的71名进行了肺活量测定和FRCpleth测量。26名儿童患有控制良好的哮喘（A组）；26名在哮喘发作期间接受测试的儿童患有未控制的哮喘（UA组），19名儿童在接受化疗后接受测试（C组）。首先在体积描记器外按照成人的建议进行测试教学，然后进行一些小的技术调整后进行测试。每次测试包括在2至3秒的阻塞期间获得的两次连续FRC测量值。计算肺总量（TLC）和残气量（RV）。将这些值与健康学龄前儿童通过氦稀释法测量的FRC（FRC-He）以及学龄儿童外推的FRCpleth值进行比较，并在各组之间进行比较。
A组肺活量测定和TLC值正常，FRCpleth和RV值轻度升高（分别为预测值的125±20和153±33%；两个值P<0.0001）。UA组显示气流阻塞，同时FRCpleth和RV升高（分别为预测值的146±26和189±38%；P<0.0001），TLC正常。C组显示限制性肺活量测定模式，同时TLC低于正常（为预测值的86±15%；P<0.0251）。
通过体积描记法测量幼儿的绝对肺容量是可行的，并且可以检测到异常的肺容量。有必要研究更多健康儿童以获取参考值，并实现该程序的标准化。
