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Published on: July 1, 2015
Sensitivity of newly defined impulse oscillometry indices in preschool children
Hanna Knihtilä1,2, Anne Kotaniemi-Syrjänen1, Anna S Pelkonen1
1Pediatric Unit of the Department of Allergology, Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
New impulse oscillometry (IOS) indices like R5-20, R5-20%, and area under the reactance curve (AX) effectively detect early lung function deficits in symptomatic children. These novel measures show higher sensitivity than traditional IOS parameters.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Tools
Background:
- Early detection of lung function deficits is crucial for managing chronic obstructive pulmonary disease (COPD) in children.
- Impulse oscillometry (IOS) is a feasible method for assessing lung function in preschool children.
- Novel IOS indices may offer enhanced sensitivity for detecting small airway dysfunction.
Purpose of the Study:
- To establish reference equations for novel IOS indices in healthy preschool children.
- To evaluate the sensitivity of these novel IOS indices in detecting lung function deficits in young symptomatic children.
- To compare the diagnostic performance of novel IOS indices against conventional parameters.
Main Methods:
- Reference equations were developed for R5-20, R5-20%, and AX using data from 103 healthy preschool children.
- IOS measurements were compared between healthy children and three groups of symptomatic children: late-onset lung symptoms, early wheeze history, and bronchopulmonary dysplasia (BPD) history.
- Statistical analysis was performed to determine significant differences in IOS parameters between groups.
Main Results:
- No significant differences were found in R5 or X5 between most patient groups and healthy children, except for X5 in the BPD group.
- Z-scores for R5-20, R5-20%, and AX were significantly higher in all patient groups compared to healthy children (P < 0.001).
- Novel IOS indices demonstrated superior sensitivity (20-55%) compared to conventional parameters (5-6%) in distinguishing symptomatic children.
Conclusions:
- R5-20, R5-20%, and AX are more sensitive than conventional IOS parameters for identifying lung function deficits in children with current or past lower respiratory tract symptoms.
- These novel IOS indices show potential as valuable screening tools for early detection of lung function impairment in pediatric populations.
- Further research may validate the clinical utility of these advanced IOS measures in pediatric respiratory health.
Introduction:
Early origins of chronic obstructive pulmonary disease have been recognized. Impulse oscillometry (IOS) is suitable for assessment of lung function also in preschool children, and some novel indices have been connected to assessment of small airway function. However, limited data exist on the sensitivity of these new indices to detect lung function deficits in young symptomatic children.
Methods:
IOS measurements of 103 healthy preschool children were evaluated to establish reference equations for the difference between respiratory resistance at 5 and 20 Hz (R5-20), the relative difference of R5-20 (R5-20%), and area under the reactance curve (AX). Thereafter, IOS results of children with late-onset troublesome lung symptoms (n = 20), a history of early wheeze (n = 37), or a history of bronchopulmonary dysplasia (BPD, n = 8) were compared to healthy children.
Results:
None of the patient groups differed from healthy regarding respiratory resistance at 5 Hz (R5), and only children with a history of BPD differed from healthy regarding respiratory reactance at 5 Hz (X5). In contrast, z-scores of R5-20, R5-20%, and AX were significantly higher in all patient groups than in healthy children (P < 0.001), showing improved sensitivity (20-55%) compared to R5 and X5 (5-6%).
Conclusion:
R5-20, R5-20%, and AX are superior to conventional IOS parameters in distinguishing children with current or past lower respiratory tract symptoms from healthy, and may prove valuable for screening early lung function deficits. Pediatr Pulmonol. 2017;52:598-605. © 2016 Wiley Periodicals, Inc.
