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Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
Forced oscillation technique as a predictor for loss of control in asthmatic children
Piyawut Kreetapirom1, Potjanee Kiewngam1, Wanlapa Jotikasthira1
1Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Forced oscillation technique (FOT) measures, particularly respiratory resistance, can predict future asthma control loss in children. These FOT parameters, combined with spirometry, offer a reliable tool for proactive asthma management.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Research
Background:
- Asthma management requires reliable objective tools to predict control status.
- Early identification of potential asthma control loss is crucial for timely intervention.
Purpose of the Study:
- To identify Forced Oscillation Technique (FOT) parameters that predict future loss of asthma symptom control in children.
- To evaluate the predictive value of FOT compared to spirometry for asthma control.
Main Methods:
- A 12-week prospective study involving 68 children (aged 6-12) with well-controlled asthma.
- Baseline evaluation included Forced Oscillation Technique (FOT) and spirometry measures, along with bronchodilator response.
- Asthma control was assessed using the Global Initiative for Asthma guidelines.
Main Results:
- 60.3% of children maintained asthma control, while 39.7% lost control.
- Significant differences were observed in baseline FOT parameters (R5, R20, %predicted R5, %∆R5, %∆R20) between children who maintained and lost control.
- Predictive factors for asthma control loss included %predicted R5, %∆R5, %predicted FEV1, and %∆FEV1, with a combined AUC of 0.924.
Conclusions:
- Forced Oscillation Technique (FOT) resistance measures provide additive value to spirometry in predicting future asthma control loss.
- Specific FOT parameters and spirometry metrics can accurately identify children at risk of losing asthma control.
Background:
A reliable objective tool using as a predictor of asthma control status could assist asthma management.
Objective:
To find the parameters of forced oscillation technique (FOT) as predictors for the future loss of asthma symptom control.
Methods:
Children with well-controlled asthma symptom, aged 6-12 years, were recruited for a 12-week prospective study. FOT and spirometer measures and their bronchodilator response were evaluated at baseline. The level of asthma symptom control was evaluated according to Global Initiative for Asthma.
Results:
Among 68 recruited children, 41 children (60.3%) maintain their asthma control between 2 visits (group C-C), and 27 children (39.7%) lost their asthma control on the follow-up visit (group C-LC). Baseline FOT parameters, including the values of respiratory resistance at 5 Hz (R5), respiratory resistance at 20 Hz (R20), respiratory reactance at 5 Hz, area of reactance, %predicted of R5 and percentage of bronchodilator response (%∆) of R5 and R20 were significantly different between C-C and C-LC groups. In contrast, only %∆ of forced vital capacity, forced expiratory volume in 1 second (FEV1), and FEF25%-75% (forced expiratory flow 25%-75%) were significantly different between groups. Multiple logistic regression analysis revealed that %predicted of R5, %∆R5, %predicted of FEV1 and %∆FEV1 were the predictive factors for predicting the future loss of asthma control. The following cutoff values demonstrated the best sensitivity and specificity for predicting loss of asthma control: %predicted of R5=91.28, %∆R5=21.2, %predicted of FEV1=89.5, and %∆FEV1=7.8. The combination of these parameters predicted the risk of loss of asthma control with area under the curve of 0.924, accuracy of 83.8%.
Conclusion:
Resistance FOT measures have an additive role to spirometric parameter in predicting future loss of asthma control.
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