Impulse oscillometry for evaluating pulmonary function in pediatric pectus deformities: a prospective controlled...

Area of Science:

• Pediatric Pulmonology
• Respiratory Physiology

Background:

• Pectus deformities (PDs) can impact pulmonary mechanics, but spirometry often fails to identify subtle abnormalities.
• Impulse oscillometry (IOS) is a sensitive, effort-independent method for assessing respiratory mechanics.

Purpose of the Study:

• To evaluate pulmonary function in children with PDs using both spirometry and IOS.
• To identify potential markers for respiratory impairment in this population.

Main Methods:

• Prospective cross-sectional study involving 73 children with PDs and 80 healthy controls.
• Spirometry and IOS testing were performed, with z-scores calculated for all parameters.
• A possible restrictive ventilatory defect was defined using z-scores for forced vital capacity (zFVC) and forced expiratory volume in 1 second (zFEV1).

Main Results:

• Children with PDs showed significantly lower zFVC and zFEV1, and higher reactance at 5 cmH2O (zAX) and reactance at 15 Hz (zX15) compared to controls.
• No obstructive pattern was observed, but 61.6% of children with PDs had a possible restrictive ventilatory defect.
• Lower body mass index (zBMI) and higher zAX independently predicted restriction.

Conclusions:

• IOS offers added value in detecting respiratory impairment in children with PDs.
• The combination of IOS and spirometry can facilitate earlier identification of functional limitations.
• zAX may serve as a useful marker for clinical decision-making and follow-up in children with PDs.