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Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Impulse oscillometry in acute and stable asthmatic children: a comparison with spirometry
Sehra Birgul Batmaz1, Semanur Kuyucu1, Tugba Arıkoglu1
1a Division of Allergy and Immunology, Department of Pediatrics , Medical School, Mersin University , Mersin , Turkey and.
Insights
Impulse oscillometry (IOS) effectively assesses childhood asthma, correlating well with spirometry. This lung function test is a viable alternative for children unable to perform spirometry maneuvers.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Tools in Asthma
Background:
- Lung function tests are crucial for diagnosing and monitoring childhood asthma.
- Spirometry requires forced expiratory maneuvers, which can be challenging for some children.
- Impulse oscillometry (IOS) offers a non-invasive, spontaneous breathing alternative.
Purpose of the Study:
- To evaluate impulse oscillometry (IOS) as a diagnostic tool for childhood asthma.
- To compare IOS parameters with spirometry in asthmatic and healthy children.
- To assess the utility of IOS in detecting airway obstruction and reversibility.
Main Methods:
- IOS and spirometry were performed on 35 acute asthmatic, 107 stable asthmatic, and 103 healthy children.
- Measurements were taken before and after salbutamol inhalation to assess reversibility.
- Statistical analyses included comparisons between groups, correlation analyses, and receiver operating characteristic (ROC) curves.
Main Results:
- Significant differences in baseline and reversibility parameters were observed between the groups.
- Area of reactance (AX) and its change (ΔAX) showed the highest discriminative ability.
- IOS parameters, including resistance and reactance, correlated significantly with spirometric indices.
- Cut-off values for ΔR5 (≤-22.34) and ΔAX (≤-39.05) identified spirometric reversibility.
Conclusions:
- Impulse oscillometry demonstrates a strong association with spirometry and reversibility testing in children.
- IOS is a promising alternative to spirometry for pediatric asthma assessment, especially for children unable to perform forced maneuvers.
Objective:
Lung function tests have attracted interest for the diagnosis and follow-up of childhood asthma in recent years. For patients who cannot perform forced expiratory maneuvers, impulse oscillometry (IOS), performed during spontaneous breathing, may be an alternative tool.
Methods:
Thirty-five acute, 107 stable asthmatic and 103 healthy children who presented to our clinic performed IOS followed by spirometry before and after salbutamol inhalation. The mean baseline and reversibility of IOS and spirometry parameters were compared between the groups. Correlation analyses were undertaken within the asthmatics, and the healthy controls separately. To distinguish the three groups, the sensitivity and specificity of baseline and reversibility values of IOS and spirometry were computed. When spirometry was taken as the gold standard, the discriminating performance of IOS to detect the airway obstruction and reversibility was investigated.
Results:
The mean absolute values of Zrs, R5, R5-R20, X5, X10, X15, Fres, AX, and all spirometric parameters, and the mean reversibility values of R5, R10, Fres, AX and forced expiratory volume in one second were different between the groups and the highest area under curve values to discriminate the groups was obtained from area of reactance (AX) and ΔAX. Zrs, all resistance (including R5-R20) and reactance parameters, Fres and AX were correlated with at least one spirometric parameter. Spirometric reversibility was detected by ≤-22.34 and ≤-39.05 cut-off values of ΔR5 and ΔAX, respectively.
Conclusions:
IOS has shown a highly significant association with spirometric indices and reversibility testing. It may be a substitute for spirometry in children who fail to perform forced expiratory maneuvers.
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