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Published on: April 8, 2022
Airwave oscillometry to measure lung function in children with Down syndrome
Monica L Vielkind1, Katharine L Hamlington2, Kristine Wolter-Warmerdam3
1Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Airwave oscillometry is a feasible method for assessing lung function in children with Down syndrome, unlike traditional spirometry. This finding supports its use in this high-risk population for better clinical care and research participation.
Area of Science:
- Pediatric Pulmonology
- Medical Devices
- Down Syndrome Research
Background:
- Children with Down syndrome face increased risks of pulmonary conditions like infections and sleep apnea.
- Standard lung function tests, such as spirometry, are often not feasible for children with intellectual disabilities.
Purpose of the Study:
- To evaluate the feasibility of airwave oscillometry and spirometry for measuring lung function in children with Down syndrome.
- To compare the success rates of these two pulmonary function tests in this population.
Main Methods:
- Thirty-four children with Down syndrome (ages 5-17) underwent airwave oscillometry and spirometry.
- Tests were performed before and after albuterol administration to assess bronchodilator response.
- Success rates and pulmonary function parameters (airway resistance, reactance) were recorded.
Main Results:
- Airwave oscillometry was successful in 76.5% of participants, while spirometry succeeded in only 11.8%.
- No significant airway resistance abnormalities were found, but 61.5% showed decreased reactance.
- A positive bronchodilator response was noted in 21.7% of participants tested with oscillometry.
Conclusions:
- Airwave oscillometry is a viable and successful method for assessing pulmonary function in children with Down syndrome.
- This technique can aid in the clinical management and research enrollment of this vulnerable group.
Background:
Children with Down syndrome are at risk for significant pulmonary co-morbidities, including recurrent respiratory infections, dysphagia, obstructive sleep apnea, and pulmonary vascular disease. Because the gold standard metric of lung function, spirometry, may not be feasible in children with intellectual disabilities, we sought to assess the feasibility of both airwave oscillometry and spirometry in children with Down syndrome.
Methods:
Thirty-four children with Down syndrome aged 5-17 years were recruited. Participants performed airwave oscillometry and spirometry before and 10 min after albuterol. Outcomes include success rates, airway resistance and reactance pre- and post-bronchodilator, and bronchodilator response.
Results:
Participants were median age 9.2 years (interquartile range 7.2, 12.0) and 47% male. Airwave oscillometry was successful in 26 participants (76.5%) and 4 (11.8%) were successful with spirometry. No abnormalities in airway resistance were detected, and 16/26 (61.5%) had decreased reactance. A positive bronchodilator response by oscillometry was observed in 5/23 (21.7%) of those with successful pre- and post-bronchodilator testing.
Conclusions:
Measures of pulmonary function were successfully obtained using airwave oscillometry in children with Down syndrome, which supports its use in this high-risk population.
Impact:
Children with Down syndrome are at risk for significant pulmonary co-morbidities, but the gold standard metric of lung function, spirometry, may not be feasible in children with intellectual disabilities. This may limit the population's enrollment in clinical trials and in standardized clinical care. In this prospective study of lung function in children with Down syndrome, airwave oscillometry was successful in 76% of participants but spirometry was successful in only 12%. This study reinforces that measures of pulmonary function can be obtained successfully using airwave oscillometry in children with Down syndrome, which supports its use in this high-risk population.
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