Use of the forced oscillation technique to assess airway obstruction and reversibility in children
Related Experiment Video
Updated: Oct 17, 2026
Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
C Delacourt1, H Lorino, M Herve-Guillot
1Service de Pédiatrie and Service de Pneumologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France. delacour@im3.inserm.fr
Insights
The forced oscillation technique (FOT) reliably detects airway obstruction and reversibility in children aged 3 and up with asthma. This passive method is valuable for pediatric respiratory assessments.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Techniques
Background:
- The forced oscillation technique (FOT) is a non-invasive method for assessing respiratory mechanics.
- Pediatric respiratory assessments often require methods with minimal patient cooperation.
- Asthma and chronic cough in children necessitate accurate methods for detecting airway obstruction and reversibility.
Purpose of the Study:
- To evaluate the sensitivity and specificity of FOT for detecting airway obstruction in children.
- To assess FOT's ability to identify bronchodilator reversibility in pediatric asthma.
- To determine the utility of FOT in children unable to perform spirometry.
Main Methods:
- Assessed baseline and post-bronchodilator resistance (R(0)) using FOT in 313 children (3-16 years).
- Normalized baseline R(0) for height and weight (R(0)(SD)).
- Correlated R(0)(SD) and its changes (DeltaR(0)(SD)) with spirometry parameters (FEV(1), MEF(50)) and analyzed receiver operating characteristic (ROC) curves.
Main Results:
- Normalized R(0)(SD) correlated with FEV(1) and MEF(50) in children performing spirometry.
- Optimal R(0)(SD) cutoffs showed 84% sensitivity and 73% specificity for detecting airflow obstruction.
- Optimal DeltaR(0)(SD) cutoffs demonstrated 69% sensitivity and 78% specificity for bronchodilator reversibility.
- FOT identified a subgroup of young children with reversible airway obstruction even without spirometry.
Conclusions:
- FOT provides a reliable method for evaluating bronchial obstruction in children over 3 years old.
- FOT is effective in assessing bronchodilator responsiveness in pediatric asthma.
- The technique is particularly useful for children unable to perform standard spirometric maneuvers.
Abstract:
The forced oscillation technique (FOT) is particularly attractive in a pediatric setting as it requires only passive cooperation from the child. We assessed the sensitivity and specificity of this method for detecting airway obstruction and its reversibility in 313 children (3 to 16 yr of age) with asthma or chronic nocturnal cough. Baseline and post-bronchodilator (n = 251) resistance were measured (R(0)) with the FOT. Baseline R(0) was normalized for height and weight [R(0)(SD)]. In children able to perform forced expiratory maneuvers (n = 181), R(0)(SD) was independently correlated with FEV(1) (p < 0.02) and maximal expiratory flow at 50% (MEF(50)) (p < 0.004). The optimal R(0)(SD) cutoff value given by receiver operating characteristic (ROC) curves to discriminate between children with baseline FEV(1) < 80% or >/= 80% of predicted values yielded 84% sensitivity and 73% specificity. Post-bronchodilator changes in R(0)(SD) [DeltaR(0)(SD)] were mostly correlated to changes in MEF(50). The optimal DeltaR(0)(SD) cutoff value to discriminate between children with the presence or absence of significant reversibility in FEV(1) yielded 69% sensitivity and 78% specificity. In children unable to perform forced expiratory maneuvers (n = 132), this DeltaR(0)(SD) cutoff clearly identified a subgroup of young children with high R(0) values at baseline, that returned to normal after bronchodilation. We conclude that FOT measurements allow reliable evaluation of bronchial obstruction and its reversibility in asthmatic children over 3 yr old.
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