Impulse oscillometry in preschool children with persistent asthma can predict spirometry at school age

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine
• Diagnostic Imaging

Background:

• Persistent asthma in children can lead to impaired lung function during preschool and school ages.
• Early identification of children at risk for persistent lung function deficits is crucial.

Purpose of the Study:

• To determine if preschool impulse oscillometry (IOS) parameters can predict spirometry alterations in school-aged children with persistent asthma.
• To assess the diagnostic accuracy of IOS parameters for predicting abnormal lung function and bronchodilator response.

Main Methods:

• A cohort of 66 children diagnosed with persistent asthma underwent IOS during preschool.
• Follow-up at school age included spirometry testing.
• Analysis focused on the predictive value of preschool IOS parameters for school-age lung function.

Main Results:

• Several preschool IOS parameters (R5, R20, Fres, AX, D5-20) demonstrated diagnostic accuracy (AUC > 0.7) for predicting abnormal school-age spirometry.
• Parameters AX, D5-20, and R5 showed high positive likelihood ratios (LR+) for predicting abnormal spirometry.
• R20, R5, and AX were effective in discriminating bronchodilator response (BDR) in schoolchildren.

Conclusions:

• Preschool IOS parameters measured between ages 3-5 are valuable predictors of abnormal spirometry at school age.
• These IOS parameters can also help predict bronchodilator response in school-aged children.
• IOS offers a non-invasive method for early risk stratification in children with persistent asthma.