Summary of lung function reference equations recommended for use in paediatrics
| Index | Author (reference) | Population (age range/ethnicity/sample size) | Limitations for a UK population | |
| Spirometry | FEV1, FVC FEV1/FVC FEF75 FEF25–75 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 transfer | TLco VA Kco | Stanojevic et al 47 | (~2000 subjects <19 years) Healthy non-smoking subjects, 4–91 years. | Limited use in non-Caucasians. |
| Plethysmographic lung volumes | FRC TLC RV | Rosenthal et al160 | 772 (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 muscles | SNIP | Rafferty 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/MEP | Lanza et al or ATS/ERS statement 2002116 177 | Lanza 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: http://www.ers-education.org/guidelines/global-lung-function-initiative.aspx.
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.