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Reference values for peak flow and FEV₁ variation in healthy schoolchildren using home spirometry

¹ Princess Amalia Children’s Clinic, Isala Clinics, Zwolle, ² Dept of Paediatric Pulmonology, University of Groningen/University Medical Center, Beatrix Children’s Hospital, Groningen, and ³ St Anna Care Group, Geldrop, the Netherlands.

CORRESPONDENCE: A. F. J. Brouwer, University of Groningen/University Medical Center, Dept of Paediatric Pulmonology, Beatrix Children’s Hospital, P.O. Box 30.001, 9700 VB Groningen, The Netherlands. Fax: 31 503611704. E-mail: brouwerafj{at}bkk.umcg.nl

Keywords: Forced expiratory volume in one second, home spirometry, peak flow variation, reference values, schoolchildren

Received: November 6, 2007
Accepted April 6, 2008

Current reference values for diurnal peak flow variation in healthy children (median 8.2%; 95th percentile 31%) are so high that considerable overlap exists with those of asthmatic children. These values have been obtained using written peak flow diaries, which are unreliable. The aim of the present study was to obtain reliable reference values for the variation in peak flow and forced expiratory volume in one second (FEV₁) in healthy schoolchildren using home spirometry with electronic data storage.

Healthy schoolchildren (n = 204; 100 males) aged 6–16 yrs measured their peak flow and FEV₁ twice daily for 2 weeks using an electronic home spirometer. The variation in peak flow and FEV₁ were calculated as a diurnal amplitude as a percentage of the day’s mean.

The mean peak flow variation was 6.2% (95th percentile 12.3%) and the mean FEV₁ variation was 5.7% (95th percentile 11.8%).

Using home spirometry with electronic data storage, healthy schoolchildren show considerably less peak flow and forced expiratory volume in one second variation than previously reported on the basis of written peak flow diaries. Being the 95th percentiles of the distributions in healthy children, a peak flow variation of 12.3% and an forced expiratory volume in one second variation of 11.8% are suggested as cut-off values for disease when using home spirometry.