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      Standard reference and percentiles of maximum respiratory pressures values of healthy children aged 7–10 years Translated title: Distribuição padrão e percentuais dos valores de pressão respiratória máxima de crianças saudáveis de 7 a 10 anos de idade

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          Abstract

          Objective:

          This study aims to present standard reference for values of maximum respiratory pressures of healthy schoolchildren, according to gender.

          Methods:

          This is a cross-sectional study involving healthy children aged 7–10 years. Data of body mass and height were evaluated to calculate body mass index (BMI). In addition, forced expiratory volume in 1 second (FEV 1) and maximal expiratory pressure values were evaluated according to the American Thoracic Society. The maximal inspiratory pressure (MIP) and data of maximal expiratory pressure (MEP) obtained in the study showed normal distribution and curves were built by the Lambda–Mu–Sigma (LMS) method, as well as the values of MIP and MEP percentiles 3, 10, 25, 50, 75, 90, and 97 for each gender.

          Results:

          MIP and MEP data were collected from 399 schoolchildren. All schoolchildren in the sample had adequate FEV 1 and BMI. The study showed an increase in respiratory pressure values with age progression. The MIP and MEP values of girls were of 53.4±11.0 and 61.8±12.5cmH 2O, respectively, and those of boys were 59.9±13.6 and 69.6±15.7cmH 2O, respectively.

          Conclusions:

          Normal curves and percentiles were developed for MIP and MEP values of healthy schoolchildren. The extreme percentiles (3rd and 97th) were determined, and a specific graph was elaborated for each group. These graphs may help clinical follow-up and therapeutic monitoring of different pediatric populations.

          Resumo

          Objetivo:

          Apresentar distribuição normal para os valores das pressões respiratórias máximas de escolares saudáveis, de acordo com o gênero.

          Métodos:

          Estudo transversal envolvendo crianças saudáveis de 7 a 10 anos. Foram avaliados os dados de massa corporal e estatura, para o cálculo do índice de massa corporal (IMC). Os valores de volume expiratório forçado no primeiro segundo (VEF 1) e pressão expiratória máxima foram avaliados de acordo com a American Thoracic Society. Os dados de pressão inspiratória máxima (PI máx) e pressão expiratória máxima (PE máx) obtidos no estudo deram origem à distribuição normal, cuja construção foi elaborada pelo método the Lambda-Mu-Sigma (LMS), bem como os percentis 3, 10, 25, 50, 75, 90 e 97 de PI máx e PI máx de cada sexo.

          Resultados:

          Os dados de PI máx e PI máx foram coletados de 399 escolares. Todos os escolares da amostra apresentavam VEF 1 e índice de massa corporal adequados. O estudo mostrou aumento dos valores de pressão respiratória com o avançar da idade. Os valores de PI máx e PI máx das meninas foram de 53,49±11,07 e 61,80±12,51cmH 2O, respectivamente; e os meninos de 59,96±13,66 e 69,68±15,72 cmH 2O, respectivamente.

          Conclusões:

          Foram desenvolvidas curvas e percentis normais para os valores de PI máx e PI máx de escolares saudáveis o que poderia auxiliar no acompanhamento clínico e terapêutico de diferentes populações pediátricas.

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          Most cited references41

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          Lung function testing: selection of reference values and interpretative strategies. American Thoracic Society.

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            ATS/ERS Statement on respiratory muscle testing.

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              Smoothing reference centile curves: The lms method and penalized likelihood

              Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.
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                Author and article information

                Journal
                Rev Paul Pediatr
                Rev Paul Pediatr
                rpp
                Revista Paulista de Pediatria
                Sociedade de Pediatria de São Paulo
                0103-0582
                1984-0462
                27 May 2022
                2022
                : 40
                : e2021007
                Affiliations
                [a ]Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil.
                [b ]Universidade Estadual de Campinas, Campinas, SP, Brazil.
                Author notes
                [* ]Corresponding author. E-mail: cacaiss@ 123456yahoo.com.br (C. I. S. Schivinski).

                Conflict of interests

                The authors declare there is no conflict of interests.

                Authors’ contribution

                Study design: Schivinski CIS, Morcillo AM. Data collection: Wamosy RMG, Parazzi PLF. Data analysis: Morcillo AM. Manuscript writing: Wamosy RMG, Schivinski CIS, Parazzi PLF, Morcillo AM. Manuscript revision: Schivinski CIS. Study supervision: Schivinski CIS, Morcillo AM.

                Declaration

                The database that originated the article is available with the corresponding author.

                Author information
                http://orcid.org/0000-0002-6139-9727
                http://orcid.org/0000-0001-5772-9650
                http://orcid.org/0000-0002-7072-603X
                http://orcid.org/0000-0002-2088-972X
                Article
                00448
                10.1590/1984-0462/2022/40/2021007IN
                9150902
                35648985
                df5c299f-1ad5-473e-b2a6-18f157915cd4

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 11 January 2021
                : 29 August 2021
                Page count
                Figures: 6, Tables: 6, Equations: 2, References: 32
                Categories
                Original Article

                respiratory muscles,children,muscle strength,músculos respiratórios,criança,força muscular

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