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Updated: Jun 21, 2026
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Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Airway response to mannitol challenge in asthmatic children using impulse oscillometry
Thomas A Horsman1, R Kimberly Duke, Paul W Davenport
1Departments of Pediatrics, University of Florida, Gainesville, Florida 32610, USA.
Summary
Impulse oscillometry (IOS) offers a simpler way to test asthma in children. This study shows IOS can effectively measure bronchial responsiveness to mannitol, an alternative to spirometry.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Allergy and Immunology
Background:
- Assessing bronchial responsiveness to mannitol in children often relies on spirometry, which can be challenging for this age group.
- Forced expiratory maneuvers used in spirometry may not be feasible for all pediatric patients.
- Alternative, effort-independent methods are needed for accurate bronchial challenge testing in children.
Purpose of the Study:
- To evaluate the efficacy of impulse oscillometry (IOS) in assessing mannitol-induced bronchial responsiveness in children with asthma.
- To determine if IOS parameters correlate with changes in forced expiratory volume in 1 second (FEV(1)) during mannitol challenge.
- To establish IOS as a viable alternative to spirometry for bronchial provocation tests in pediatric populations.
Main Methods:
- A mannitol bronchial provocation test was conducted on pediatric asthma patients aged 8-21 years.
- Impulse oscillometry (IOS) measuring resistance (R5, R20) and spirometry measuring FEV(1) were performed at baseline and post-mannitol doses.
- Bronchial responsiveness was defined by specific percentage changes in FEV(1) or IOS R5.
Main Results:
- A significant correlation was observed between changes in FEV(1) and changes in IOS R5.
- Subjects with a positive mannitol challenge showed a significant decrease in FEV(1) and a significant increase in R5.
- No significant changes were noted in R20 or in FEV(1)/R5 in subjects with a negative challenge.
- A greater than or equal to 25% increase in R5 was identified as an indicator of a positive mannitol challenge.
Conclusions:
- Effort-independent impulse oscillometry (IOS) is a practical and effective tool for assessing bronchial responsiveness to mannitol in children.
- IOS provides a valuable alternative to spirometry for pediatric patients who struggle with forced expiratory maneuvers.
- IOS R5 measurements can reliably detect airflow obstruction during mannitol challenges in asthmatic children.
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