Related Experiment Video
Updated: Sep 29, 2025
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Impulse Oscillometry System for the Diagnosis of Wheezing Episode in Children in Office Practice
Suhas Kulkarni1, Anil Kurane1, Deepak Sakate2
1Department of Pediatrics, D.Y. Patil Medical College, Kolhapur, Maharashtra, India.
Insights
Impulse oscillometry (IOS) can help distinguish pediatric wheezing from other respiratory issues. Changes in actual IOS parameters like AX, R5, and X20 significantly differed in children with wheezing episodes.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Tools
Background:
- Differentiating pediatric wheezing episodes from other respiratory disorders is crucial for effective office-based treatment.
- Impulse oscillometry system (IOS) is a valuable tool for assessing airway resistance in young children (3-6 years).
- Geographical variations in reference values currently limit the widespread use of IOS.
Purpose of the Study:
- To evaluate the utility of impulse oscillometry (IOS) in differentiating wheezing episodes from other respiratory conditions in children aged 3-6 years.
- To compare the diagnostic accuracy of absolute IOS parameter changes versus percentage changes relative to predicted values.
Main Methods:
- Recruited 106 children aged 3-6 years with symptoms suggestive of respiratory illness.
- Performed impulse oscillometry (IOS) before and after salbutamol nebulization.
- Followed up patients for 7 days to establish a final diagnosis, analyzing data from 83 children.
Main Results:
- Statistically significant differences (p<0.001) were observed in the change of actual IOS values (AX, R5, X20) between the wheezing and non-wheezing groups.
- Percentage changes in R5 and X20 compared to predicted values also showed significant differences (p<0.001) between groups.
- 83 children (47 male, 36 female) completed the study.
Conclusions:
- Changes in actual IOS parameters (AX, R5, X20) can effectively differentiate wheezing episodes from other respiratory diseases in children.
- The study highlights the potential of IOS as an objective diagnostic tool in pediatric respiratory care.
Background And Objective:
Objectively differentiating between wheezing episodes and other respiratory disorders will be helpful in treatment in office practice. The impulse oscillometry system has been useful in assessing airway resistance in children 3-6 years old. As the reference values are different in geographical regions the use of the impulse oscillometry is still limited. Comparison between the percent change in IOS parameters as compared to reference standards and changes in actual IOS parameters was done to diagnose wheezing episodes.
Methodology:
Three to six years old children with a history of fever, cough, cold, and/or breathlessness with noisy breathing and who were not on any regular medications, whose parents gave consent were recruited in the study. The children underwent an impulse oscillometry system examination as per the guidelines. The test was repeated after they were given nebulization by salbutamol (2.5 mg) (before COVID 19 pandemic). Final diagnosis was done by following patients for 7 days.
Results:
About 106 children were recruited in the study. Five children could not perform the IOS test. Eighteen children did not complete the follow-up. Hence, 83 children were analyzed. There were 47 males and 36 female patients. The change in actual values of AX, R5, and X20 showed statistically significant difference in wheezing episode group (p-value<0.001). The percentage change as compared to predicted values of R5 and X20 also showed a statistically significant difference in the wheezing episode group and the others group (p-value<0.001).
Conclusion:
The change in actual values of AX, R5, X20, and resonant frequency may help to differentiate wheezing episode from other respiratory diseases.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:24Pulse Oximetry
Purpose
Average SpO2 values are greater than 95%. If the readings fall below 90%, it indicates that...
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:25Pulmonary Function Tests
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...