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Reference Values for Respiratory Impedance in Bulgarian Children Aged 2-8 Years Using the Forced Oscillation

Plamena Stoimenova1, Stoilka Mandadzhieva1, Blagoi Marinov1

  • 1Department of Pathophysiology, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.

Children (Basel, Switzerland)
|July 29, 2025
PubMed

Insights

Height is the primary factor influencing respiratory impedance in children aged 2-8. This finding supports using height for developing reference values for the forced oscillation technique (FOT) in early childhood.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Physiology
  • Biomedical Engineering

Background:

  • The forced oscillation technique (FOT) offers a non-invasive, effort-independent method for assessing respiratory mechanics.
  • FOT is especially valuable for young children unable to perform spirometry reliably.

Purpose of the Study:

  • To identify key anthropometric determinants of respiratory resistance (Rrs) and reactance (Xrs) in healthy Bulgarian children.
  • To evaluate the relationship between FOT parameters and anthropometric measurements in children aged 2 to 8 years.

Main Methods:

  • 100 healthy Bulgarian children (2-8 years) underwent FOT measurements at 5, 11, and 19 Hz.
  • Anthropometric data (height, weight) were collected; stepwise multiple linear regression was used.
  • Measurements followed American Thoracic Society/European Respiratory Society guidelines.

Main Results:

  • Height was the most significant determinant of both Rrs and Xrs across all tested frequencies.
  • A moderate inverse correlation was found between Rrs at 5 Hz and height (r = -0.446; p < 0.001).
  • Weight influenced reactance at 5 Hz; sex and age showed no significant effect.

Conclusions:

  • Height is the strongest predictor of respiratory impedance in young children.
  • Prioritizing height is crucial for establishing normative FOT reference values in children under 8.
  • These findings underscore the clinical utility of FOT in early childhood assessment.

Keywords:
childrendeterminantsforced oscillation techniquepulmonary function testingreference values

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