Table 9

Summary of lung function reference equations recommended for use in paediatrics

IndexAuthor (reference)Population
(age range/ethnicity/sample size)
Limitations for a UK population
SpirometryFEV1, FVC
FEV0.75 and FEV0.75/FVC—in children aged 3–7 years
Quanjer et al44>74 000 healthy non-smoking subjects 3–95 years.
5 ethnic groups: Caucasian; Black American; South East Asian; North East Asian; Other/Mixed.
No published data on the Indian subcontinent.
No predicted values for PEF.
Gas transferTLco
Stanojevic et al
(~2000 subjects <19 years) Healthy non-smoking subjects, 4–91 years.Limited use in non-Caucasians.
Plethysmographic lung volumesFRC
Rosenthal et al160772 (455 male) Caucasian children aged 4–19 years, included pubertal assessments.Have pubertal breakpoints.
Based on just height, thus does not appropriately predict for those short-for-age.
Respiratory musclesSNIPRafferty et al or
Stefanutti et al162 163
Rafferty et al: 116 children from a single school, multiethnicity, aged 4–11 years (54 girls)
Stefanutti et al: 180 Caucasian children (93 boys).
Limited sample size (Rafferty et al).
Limited use in non-Caucasians (Stefanutti et al).
MIP/MEPLanza et al or ATS/ERS statement 2002116 177Lanza et al: 450 Brazilian children (238 girls).
ATS/ERS: multicentre study.
Lanza et al: not validated in a UK population.
  • It is important to liaise with your local manufacturer to ensure you have the most appropriate prediction module installed for your population.

  • It is recommended that you regularly check for updates of reference equations with the ARTP Paediatric and Standards Committee and at the GLI website:

  • ARTP, Association for Respiratory Technology & Physiology; ATS, American Thoracic Society; ERS, European Respiratory Society; FEF, forced expiratory flow; FEV1, forced expiratory volume in 1 s; FRC, functional residual capacity; FVC, forced vital capacity; GLI, Global Lung Function Initiative; Kco, gas transfer coefficient for carbon monoxide; MEP, maximal expiratory pressure; MIP, maximal inspiratory pressure; PEF, peak expiratory flow; RV, residual volume; SNIP, sniff nasal inspiratory pressure; TLC, total lung capacity; TLco, carbon monoxide transfer factor; VA, alveolar volume.