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Updated: Nov 10, 2025
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Impulse oscillometry and free-running tests for diagnosing asthma and monitoring lung function in young children
Janne Burman1, Leo Pekka Malmberg1, Sami Remes2
1Department of Allergology, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Insights
Impulse oscillometry is effective for diagnosing and monitoring asthma in young children. This method helps evaluate treatment response to inhaled corticosteroids (ICS), improving lung function and asthma control.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Diagnostic Tools
Background:
- Differentiating viral-induced wheezing from asthma in young children (<6 years) is challenging.
- Established guidelines for this age group are lacking.
- Impulse oscillometry has shown feasibility in 4-year-old children.
Purpose of the Study:
- To assess impulse oscillometry for diagnosing asthma in young children.
- To monitor asthma progression and lung function in pediatric patients.
- To evaluate treatment response to inhaled corticosteroids (ICS) in children with asthma.
Main Methods:
- A cohort of 42 children (median age 5.3 years) with diagnosed asthma underwent 6 months of ICS treatment.
- Impulse oscillometry and the 6-minute free-running test were performed at three time points.
- Asthma control and hyperreactivity were assessed to define a positive ICS response.
Main Results:
- 38 out of 42 children showed a positive response to ICS treatment.
- Significant reduction in exercise-induced bronchoconstriction and improved running distance were observed.
- Childhood asthma control scores improved, and acute physician visits for respiratory symptoms decreased.
Conclusions:
- Impulse oscillometry is a valuable tool for asthma diagnosis in young children.
- It aids in monitoring lung function and treatment efficacy.
- This technique supports clinical management of pediatric asthma.
Background:
Separating individuals with viral-induced wheezing from those with asthma is challenging, and there are no guidelines for children under 6 years of age. Impulse oscillometry, however, is feasible in 4-year-old children.
Objective:
To explore the use of impulse oscillometry in diagnosing and monitoring asthma in young children and evaluating treatment response to inhaled corticosteroid (ICS).
Methods:
A total of 42 children (median age 5.3 years, range 4.0-7.9 years) with physician-diagnosed asthma and lability in oscillometry were followed for 6 months after initiation of ICS treatment. All children performed the 6-minute free-running test and impulse oscillometry at 3 time points. After the baseline, they attended a second visit when they had achieved good asthma control and a third visit approximately 60 days after the second visit. A positive ICS response was defined as having greater than 19 points in asthma control test and no hyperreactivity on the third visit.
Results:
In total, 38 of 42 children responded to ICS treatment. Exercise-induced increases of resistance at 5 Hz decreased after ICS treatment (61% vs 18% vs 13.5%, P < .001), and running distance during the 6-minute test was lengthened (800 m vs 850 m vs 850 m, P = .001). Significant improvements in childhood asthma control scores occurred between the baseline and subsequent visits (21 vs 24 vs 24, P < .001) and acute physicians' visits for respiratory symptoms (1, (0-6) vs 0, (0-2), P = .001). Similar profiles were observed in children without aeroallergen sensitization and among those under 5 years of age.
Conclusion:
Impulse oscillometry is a useful tool in diagnosing asthma and monitoring lung function in young children.
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