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Updated: Apr 28, 2026
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Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
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Assessing direct and indirect airway hyperresponsiveness in children using impulse oscillometry
Satu Kalliola1, L Pekka Malmberg1, Merja Kajosaari2
1Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Summary
Impulse oscillometry (IOS) effectively identifies airway hyperresponsiveness (AHR) in young children. Methacholine and exercise challenges using IOS can help diagnose probable asthma in children with lung symptoms.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Tools
Background:
- Airway hyperresponsiveness (AHR) is a key asthma indicator, but spirometry is challenging for young children.
- Impulse oscillometry (IOS) offers a less cooperative method for lung function assessment in pediatric populations.
Purpose of the Study:
- To determine if IOS-based AHR assessment can distinguish between pediatric obstructive symptom groups.
- To evaluate the utility of IOS in diagnosing respiratory conditions in young children.
Main Methods:
- 121 children (median age 6.0 years) with probable asthma, early wheezing, bronchopulmonary dysplasia, and controls underwent IOS.
- Direct AHR assessed via methacholine challenge; indirect AHR via exercise and mannitol challenges.
- A 40% increase in respiratory resistance at 5 Hz defined AHR.
Main Results:
- Exercise challenge with IOS differentiated children with current lung symptoms from others (P < .001).
- Methacholine challenge using IOS distinguished probable asthma, early wheezing, and BPD groups from controls (P < .001).
- Mannitol challenge did not differentiate study groups (P = .209).
Conclusions:
- Methacholine and exercise challenge tests using IOS are practical tools for evaluating AHR in young children.
- These IOS-based tests aid in identifying probable asthma in children with troublesome lung symptoms.
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