Normative Reference Values and Determinants of Pulmonary Function in Healthy Children and Adolescents: A Systematic Review and Meta-analysis
Abstract
Objective: Spirometry is one of the most vital assessment tools for evaluating pulmonary function inindividuals. However, its reference values in various populations are different. This variation is most evidentin children due to various variables like ethnicity, methodological variations, growth spurts, gaps inunderstanding and performing PFT, etc. Over or underestimation of normative values can misdiagnose a childfor a pulmonary disorder. Hence, the present study aims to analyze different studies throughout the globe forreference values of PFT (FEV1, FVC, FEV1/FVC, PEFR) in healthy children as well as adolescents.Materials and methods: Various studies reporting normative values of PFT in healthy school-going childrenbetween 1990 and 2024 were extracted from Google Scholar, PubMed and CINHAL according to inclusioncriteria through the Rayyan platform. A total of 22 studies (16,754 cildren) were included using PRISMAguidelines. The required information was extracted by full-text review. Quality of studies was assessed usingthe QUADAS scale. A random-effects model and forest plots for pulmonary functions (FVC, FEV1, PEFRand FEF 25%-75%) were used to estimate heterogeneity and variations between studies in relation to gender.Results: The pooled mean of FVC, FEV1, PEFR and FEF 25% - 75% was 2.53, 2.16, 4.77 and 2.92 liters forboys and 2.16, 1.92, 4.43 and 2.56 liters for girls, respectively. The heterogeneity was as high as 97.37 % formean values of PEFR to minimum of 87.73 %…
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