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Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Pulmonary function using impulse oscillometry system and clinical outcomes at age 4 years in children born extremely
Celine Delestrain1, Kamel Halitim2, Manon Tauzin3
1Centre Hospitalier Intercommunal de Créteil, Service de Pédiatrie Générale, Créteil, 94000, France; Centre des Maladies Respiratoires Rares (RESPIRARE®), CRCM, Créteil, France; University Paris Est Créteil, INSERM, IMRB, 94010, Créteil, France; FHU SENEC, Créteil, France.
Insights
Most extremely preterm children have abnormal airway resistance by age 4, regardless of bronchopulmonary dysplasia (BPD). Early lung function assessment using impulse oscillometry is crucial for monitoring these high-risk infants.
Area of Science:
- Pediatric Pulmonology
- Neonatology
- Respiratory Medicine
Background:
- Extremely preterm infants face significant risks for respiratory complications.
- Bronchopulmonary dysplasia (BPD) is a common comorbidity affecting lung development in these infants.
- Early identification of lung function deficits is essential for timely intervention.
Purpose of the Study:
- To assess early lung function and respiratory morbidity in extremely preterm children.
- To compare lung function between extremely preterm children with and without BPD.
- To evaluate the utility of impulse oscillometry for early detection of respiratory abnormalities.
Main Methods:
- Prospective study of infants born at ≤28 weeks gestational age.
- Lung function (impulse oscillometry), respiratory morbidity, and growth assessed at 4 years.
- Comparison of lung function parameters (resistance, reactance) between children with and without BPD.
Main Results:
- 76% of extremely preterm children exhibited elevated respiratory resistance (R5) at age 4, irrespective of BPD status.
- No significant differences in resistance (R5, R20) or reactance (X5) were found between BPD and non-BPD groups.
- Asthma symptoms were prevalent (30%) in the cohort, independent of BPD.
- Bronchodilator treatment did not significantly alter resistance measurements.
Conclusions:
- Impulse oscillometry reveals widespread abnormal airway resistance in preschool children born extremely preterm.
- Lung function deficits are common in this population, even without a history of BPD.
- Impulse oscillometry is a valuable tool for early lung function assessment in extremely preterm infants.
Abstract:
This study aimed to describe the early assessment of lung function and respiratory morbidity in children born extremely preterm with or without bronchopulmonary dysplasia (BPD).
Methods:
This was a prospective study including all the children born at gestational age ≤28 weeks who received treatment in the NICU of the Centre Intercommunal de Créteil in France, from January 2006 to March 2012. Lung function, using the impulse oscillometry system, respiratory morbidity and growth were assessed at age 4 years. Lung function and clinical course of children were compared in children with and without BPD.
Results:
We included 136 extremely premature children; 26 (19 %) had BPD. Children with and without BPD did not significantly differ in resistance measurements at 5 Hz (R5) and 20 Hz (R20) and reactance (X5) measurements at age 4 years. A total of 104 (76 %) pre-term children had respiratory resistance R5 above the 95th percentile for the reference population (z-score >1.64), regardless of BPD status. The mean (SD) R5 z-score for all children was 2.1 (±0.7), whereas the mean (SD) R20 was in the normal range (z-score = 1.1 [±0.3]). After treatment with bronchodilators, all children showed no significant change in resistance. The prevalence of asthma symptoms at age 4 years was common and estimated at 30 % regardless of BPD status.
Conclusion:
Early assessment of lung function by the impulse oscillometry system revealed that most preschool children who were born extremely preterm had abnormal total airway resistance regardless of BPD status. The system is an essential tool for the early assessment of children born prematurely.
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