[Maximal respiratory pressures in children: the methodological challenge].

Introduction: Measurement of maximal respiratory pressures against an occlusion has been used for a long time to assess respiratory muscle strength in the follow up of children with respiratory disease. In the early stage of disease this is the main test for diagnosing respiratory muscle involvement and the degree of that involvement. STATE OF KNOWLEDGES: The interpretation of the results is difficult on account of variability of the measurements and of the reference values. The aim of this article is to present, in the form of a literature review, the normal values available and the different determining factors as well as the advantages and limitations of these measurements.

Perspectives: The use by all the centres undertaking maximal respiratory pressure measurements in children of methodological techniques similar to those presented in this revue could be the starting point for obtaining an identical range of reference values for all.

Conclusion: Age, sex and the level of physical aptitude seem to be the most important determinants of maximal respiratory pressures. However, other methodological factors such as co-operation, training of the child in the performance of the manoeuvres and the type of device and protocol used, will all influence the results. These factors must be taken into consideration in order to diminish, as much as possible, the variability of the maximal pressures obtained.