Related Experiment Video
Updated: Aug 17, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Variability analysis of oscillatory airway resistance in children
Hubert Trübel1, Wolfgang K R Banikol
1Zentrum für Kinderheilkunde und Jugendmedizin, HELIOS Klinikum Wuppertal, University of Witten/Herdecke, Wuppertal, Germany. htruebel@wuppertal.helios-kliniken.de
Insights
Variability in oscillatory airway resistance measurements can distinguish children with asthma from healthy controls. This method requires minimal cooperation, offering a potential diagnostic tool for pediatric asthma and bronchial hyperresponsiveness.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Asthma Diagnostics
Background:
- Pulmonary function testing in young children is challenging due to cooperation issues, especially during diagnostic procedures like bronchial provocation tests.
- Diagnosing conditions like bronchial hyperresponsiveness in preschool children requires reliable methods that minimize patient cooperation demands.
Purpose of the Study:
- To investigate if variability in oscillatory airway resistance can differentiate asymptomatic children with asthma from healthy controls.
- To assess the potential of using minimal-cooperation measurements for diagnosing pediatric respiratory conditions.
Main Methods:
- Utilized the monofrequency forced oscillation technique to continuously measure oscillatory resistance (Ros) at 10 Hz.
- Calculated variability measures (SD, LD, RMSSD) from 40 consecutive end-expiratory (Ros(pe)) and end-inspiratory (Ros(pi)) values in 36 asthmatic and 21 healthy children.
- Applied heart rate variability analysis techniques to quantify airway diameter variability.
Main Results:
- Airway diameter variability, assessed by SD, LD, and RMSSD of Ros(pi) and Ros(pe), was significantly greater in children with asthma compared to healthy controls.
- No significant differences were found in the mean values of Ros(pi) and Ros(pe) between the asthmatic and healthy groups.
- The study identified increased airway diameter variability as a key differentiator in asymptomatic asthmatic children.
Conclusions:
- Increased airway diameter variability, measured by oscillatory resistance, effectively distinguishes asymptomatic children with asthma from healthy peers.
- The variability of end-inspiratory oscillatory resistance (Ros(pi)) shows promise as a cooperative-independent measure for assessing bronchial hyperresponsiveness.
- Further research is warranted to validate this method as an alternative to traditional challenge tests for pediatric asthma diagnosis.
Abstract:
Testing pulmonary function in preschool children is problematic since individual cooperation is often insufficient to yield adequate results. This is especially the case when repetitive measurements are carried out, e.g., during provocation tests in order to diagnose bronchial hyperresponsiveness. We therefore sought to determine whether the variability of the oscillatory airway resistance, which can be measured with minimal patient cooperation, might serve as an approach to separate asymptomatic children with asthma from age-matched healthy controls. Monofrequent forced oscillation technique was used to measure the oscillatory resistance (Ros) continuously at a repetition rate of 10 Hz. Forty consecutive values of Ros at the end of expiration (Ros(pe)) and at the end of inspiration (Ros(pi)) were used to calculate variability measures [standard deviation (SD), averaged deviation (LD), root mean square successive differences (RMSSD)] known from heart rate variability analysis to describe the airway diameter variability in 36 asthmatics and 21 healthy controls. Airway diameter variability of Ros(pi) and Ros(pe) as expressed by SD from the mean (P = 0.01 and 0.05, respectively), from LD (P = 0.01 and 0.21, respectively) and from the RMSSD (P = 0.006 and 0.03, respectively) was greater in patients with asthma. Mean values of Ros(pi) and Ros(pe) were not different between groups. Airway diameter variability is higher in asymptomatic children with asthma than in healthy controls. Future research should evaluate whether the measurement of the variability of Ros(pi), which does not require the patient's cooperation, can give similar information as challenge tests with respect to bronchial hyperresponsiveness.
Related Concept Videos
01:19Factors Affecting Pulmonary Ventilation
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
01:15Respiratory Volumes
Tidal Volume (TV) Tidal volume (TV) is the air inhaled or exhaled in a...
01:30Application of Integration: Problem Solving
01:29Assessment of Ventilation II: Respiratory Depth and Rhythm
Respiratory depth measures the volume of air inhaled or exhaled during a breath. It can vary from shallow to deep and typically remains consistent when a person is at rest or asleep. Occasionally, individuals will automatically inhale deeply, known as sighing, which inflates the lungs with more air than normal breathing.
To assess respiratory depth, observe the degree of chest excursion or movement:
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration can...