Childhood Interstitial Lung Disease Standardised Oprating Procedure – Spirometry

This information paper, developed by Lung Foundation Australia in partnership with chILDRANZ, provides a comprehensive standardised operating procedure for spirometry in the assessment and monitoring of lung function in children with suspected or confirmed childhood interstitial lung disease (chILD). Spirometry is a critical diagnostic and monitoring tool used to evaluate respiratory symptoms, measure the impact of disease on pulmonary function, screen at-risk individuals, assess pre-operative risk, and guide clinical decision-making. This resource outlines clear diagnostic and monitoring indications, offering best-practice guidance on performing, interpreting and repeating key spirometry manoeuvres including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), inspiratory capacity (IC), and maximum voluntary ventilation (MVV).

The document describes in detail how to conduct accurate, reproducible tests in children as young as five years old, including guidance on calibration, coaching, equipment standards, test posture, and step-by-step procedures for both open and closed circuit methods. Protocols for VC, IC and MVV manoeuvres are outlined to help clinicians gain a complete picture of lung function. Special emphasis is placed on ensuring repeatability, correct technique, and using child-appropriate instructions to achieve reliable results. It also outlines flow range and accuracy recommendations, graphical output standards, and calibration benchmarks aligned with international best practice from the American Thoracic Society and European Respiratory Society, improving global alignment.

This resource is designed to support paediatric respiratory clinicians, technicians, and allied health professionals to safely and effectively assess lung function and disease progression in children with chILD. By promoting consistent and evidence-based spirometry testing, the guide supports early detection, accurate diagnosis, and improved clinical outcomes. It is an essential component of a multidisciplinary care approach and a key reference for respiratory health professionals working in Australia and New Zealand to optimise paediatric lung health and reduce long-term respiratory complications through timely, informed interventions.