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Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Impulse oscillometry: pulmonary function assessment in preschool children
Décio Medeiros1,2, Pedro Castro2,3, Ana Caroline Dela Bianca1,2
1Department of Maternal-Child Health, Universidade Federal de Pernambuco (UFPE) , Recife, Brazil.
Insights
Impulse Oscillometry System (IOS) can assess preschooler lung function. Children with respiratory symptoms showed higher resistance (R5Hz and R5-R20Hz) compared to healthy peers before bronchodilator use.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Spirometry is challenging for preschoolers due to cooperation requirements.
- Impulse Oscillometry System (IOS) offers a low-cooperation alternative for pediatric lung function testing.
- Early detection of lung function changes is crucial for managing conditions like asthma.
Purpose of the Study:
- To compare Impulse Oscillometry System (IOS) results in preschool children with and without respiratory symptoms.
- To evaluate the utility of IOS as a spirometry alternative in young children.
Main Methods:
- A cross-sectional study involving 76 children aged 3-6 years.
- Children were grouped based on respiratory symptoms using a validated questionnaire.
- IOS parameters (R5Hz, R20Hz, X5Hz, R5-R20Hz) were measured before and after bronchodilation.
Main Results:
- 55 out of 76 preschoolers reported respiratory complaints.
- IOS measurements demonstrated high reliability (R5Hz variability ≤17% in 92.1% of children).
- Children with respiratory symptoms exhibited higher R5Hz and R5-R20Hz values pre-bronchodilation compared to asymptomatic children.
Conclusions:
- IOS effectively differentiates lung resistance in preschool children with and without respiratory symptoms.
- Higher resistance values (R5Hz, R5-R20Hz) indicate potential airway obstruction in symptomatic children.
- IOS is a viable tool for pediatric pulmonary function assessment, especially for those unable to perform spirometry.
Objectives:
In contrast to spirometry, which requires active participation of the individual and is challenging for the preschool age group, the impulse oscillometry system comprises a test that minimizes the degree of coordination required. The study aimed to compare the results of Impulse Oscillometry System (IOS) in children with and without respiratory symptoms.
Methods:
A cross-sectional study was conducted in children aged between 3 and 6 years. A short version of the ATS-DLD-78-C questionnaire validated for Brazilian children was applied to identify two groups: children with and without respiratory symptoms. The IOS analysis was carried out measuring the following parameters in triplicate: resistance at 5 Hz (R5Hz) and 20 Hz (R20Hz), respiratory reactance at 5 Hz (X5Hz), and R5-R20Hz before and after bronchodilator application.
Results:
A total of 76 preschoolers were selected, 55 (72.4%) of whom had respiratory complaints. The coefficient of variability of R5Hz was ≤17% in 70/76 (92.1%) of the children. Resistances at R5Hz and R5-R20Hz in the children with respiratory complaints reached values higher than those of children without symptoms before bronchodilation.
Conclusions:
The results obtained for resistance using IOS in children with respiratory symptoms were higher in the pre-bronchodilator examination for R5Hz and R5-R20Hz compared to those of children without respiratory symptoms.
Expert Opinion:
Prospective investigations suggest that irreversible changes in lung function begin in infancy, before reaching school age. Pulmonary function follow-up in children with recurrent wheezing or asthma is important for confirmation of diagnosis and evaluation of the disease severity. The Impulse Oscillometry System (IOS) can be useful in assessing children's pulmonary function since it requires minimal patient cooperation and can be successfully applied to preschool children being an alternative to individuals who have difficulty performing spirometry.
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