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Impulse oscillometry provides an effective measure of lung dysfunction in 4-year-old children at risk for persistent
Alex Marotta1, Mary D Klinnert, Marcella R Price
1Division of Pediatric Allergy and Immunology, National Jewish Medical and Research Center, and the Department of Pediatrics, University of Colorado Health Sciences Center, Denver, 80206, USA.
Insights
Impulse oscillometry (IOS) effectively identifies early asthma in 4-year-olds, showing abnormal bronchodilator responses. This lung function test is valuable for diagnosing childhood asthma and monitoring early interventions.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Diagnostic Tools
Background:
- Objective lung function measurements are crucial for asthma diagnosis and management.
- The utility of these measures in very young children remains underexplored.
Purpose of the Study:
- To evaluate the diagnostic value of impulse oscillometry (IOS) and spirometry in assessing bronchodilator responses in 4-year-old children at risk for asthma.
- To compare the effectiveness of IOS with conventional spirometry in this age group.
Main Methods:
- Participants were 4-year-old children from the Childhood Asthma Prevention Study, assessed for asthma and atopy.
- Lung function was measured using IOS and spirometry before and after albuterol administration.
- IOS parameters included airways resistance and reactance at various frequencies, and resonant frequency.
Main Results:
- IOS demonstrated significant differences in bronchodilator responses (Delta resistance at 5 Hz and 10 Hz) between asthmatic and non-asthmatic children.
- IOS effectively distinguished atopic asthmatic children, showing significant differences in Delta resistance and Delta reactance.
- Conventional spirometry did not yield statistically significant findings in differentiating these groups.
Conclusions:
- Impulse oscillometry reveals abnormal bronchodilator responses in 4-year-old children, indicative of early or persistent asthma.
- IOS serves as a valuable diagnostic tool for early asthma detection in young children.
- IOS may also function as an objective measure for evaluating the efficacy of early asthma interventions.
Background:
Objective lung function measurements are routinely used to diagnose and manage asthma, but their utility for young children has not been defined.
Objective:
Bronchodilator responses were measured by means of impulse oscillometry (IOS) and compared with conventional spirometry to determine the value of lung function measures in 4-year-old asthma-prone children.
Methods:
The study participants were in the Childhood Asthma Prevention Study (National Institute of Health/National Institute of Allergy and Infectious Diseases) and at risk for asthma. At age 4 years, concurrent asthma was determined by using a previously validated modified American Thoracic Society questionnaire. Children performed IOS and spirometry before and after albuterol administration and underwent skin prick testing to 13 common allergens to assess atopy. IOS measures were as follows: airways resistance at 5 Hz and 10 Hz, airways reactance at 5 Hz and 10 Hz, and resonant frequency.
Results:
Asthmatic patients versus nonasthmatic patients significantly differed in their IOS-assessed bronchodilator responses through Delta resistance at 5 Hz (medians, 27% vs 17%; P =.02) and Delta resistance at 10 Hz (24% vs 16%; P =.03). Because atopic children who have frequent wheezing are at risk for persistent asthma, the data were analyzed in regard to atopic patients with or without asthma. IOS strongly distinguished atopic asthmatic children through Delta resistance at 5 Hz (36% vs 13%, P =.007), Delta resistance at 10 Hz (25% vs 11%, P =.02), and Delta reactance at 10 Hz (47% vs 12%, P =.03). Conventional spirometry did not establish similar statistically significant findings.
Conclusion:
IOS bronchodilator responses are remarkably abnormal in 4-year-old children, who are most likely to have persistent asthma. IOS is a useful diagnostic tool in early asthma development and might be a helpful objective outcome measure of early interventions.
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