Preschool oscillometry and lung function at adolescence in asthmatic children
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Updated: Apr 15, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Hanna Knihtilä1, Anne Kotaniemi-Syrjänen1, Mika J Mäkelä1
1Pediatric Unit of the Department of Allergology, Skin and Allergy Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
Insights
Preschool impulse oscillometry (IOS) in children with asthma can predict adolescent lung function. Normal IOS results suggest good lung health later in life, while abnormal results may indicate future impairment.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Reduced lung function in early childhood is linked to persistent respiratory symptoms and long-term impairment.
- Impulse oscillometry (IOS) is a feasible method for assessing lung function in preschool children.
- Specific IOS parameters like respiratory resistance at 5 Hz (Rrs5) and frequency dependence of resistance (dRrs/df) may indicate small airway dysfunction.
Purpose of the Study:
- To investigate whether preschool impulse oscillometry (IOS) parameters can predict lung function in adolescence among children with asthma.
- To determine the association between early-life IOS measurements and later spirometry outcomes.
Main Methods:
- Analysis of medical data from 154 asthmatic children who underwent IOS between ages 2-7 and spirometry between ages 12-18.
- Comparison of IOS parameters with post-bronchodilator spirometry results.
- Multivariate modeling to estimate the association between preschool IOS and adolescent lung function.
Main Results:
- Preschool Rrs5 and dRrs/df significantly correlated with post-bronchodilator forced expiratory volume in 1 second (FEV1) at adolescence.
- Increased Rrs5 and decreased dRrs/df in preschool were significantly associated with decreased adolescent FEV1, even after adjusting for other factors.
- Similar associations were observed with other spirometric lung function parameters.
Conclusions:
- Preschool impulse oscillometry (IOS) in asthmatic children is associated with spirometric lung function in adolescence, though with considerable variability.
- Normal preschool IOS may predict favorable lung function outcomes.
- IOS could potentially serve as an early screening tool for identifying lung function deficits and risk of impairment in young children, preceding spirometry's utility.
Introduction:
Reduced lung function in early childhood is associated with persistent symptoms and low lung function later in life. Impulse oscillometry (IOS) is feasible for assessing lung function also in preschool children, and some of the parameters, such as respiratory resistance at 5 Hz (Rrs5) and the frequency dependence of resistance (dRrs/df), have been suggested to reflect small airway dysfunction. Whether changes in preschool IOS predict later lung function remains unknown.
Methods:
The medical data of 154 asthmatic children with IOS performed at 2-7 years and spirometry at 12-18 years were analyzed. IOS and post-bronchodilator spirometry parameters were compared, and the association was estimated in a multivariate model.
Results:
Measured at preschool age, particularly Rrs5 and dRrs/df were significantly correlated with post-bronchodilator forced expiratory volume in 1 sec (FEV1) at adolescence (Rrs5: r = -0.223, P = 0.005; dRrs/df: r = 0.234, P = 0.004). Although the number of children with decreased FEV1 was low, associations of increased Rrs5 (odds ratio (OR) 5.9, 95% confidence interval (CI) 1.7; 20.9) and decreased dRrs/df (OR 8.2, 95% CI 1.7; 39.6) with decreased FEV1 remained significant in multivariate analyses. Similar findings were observed also with other spirometric parameters.
Conclusion:
In asthmatic children, preschool IOS is associated with spirometric lung function at adolescence, but the scatter is wide. Normal preschool IOS seems to indicate favourable lung function outcome, whereas in some individuals IOS could potentially be of clinical use, at a younger age than spirometry, to screen lung function deficits and increased risk for later lung function impairment.
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