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Assessment of bronchodilator response using forced oscillation technique in paediatric asthmatic patients from
Sachin B Rathod1, Smita R Sorte1, Mrunal S Phatak1
1Department of Physiology, AIIMS Nagpur, Maharashtra, India.
Insights
The forced oscillation technique (FOT) effectively measures airway reversibility in children with asthma. Parameters like R5-20 and Ax show promise for clinical use in paediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Medical Technology
Background:
- Spirometry is challenging for diagnosing and monitoring paediatric asthma due to effort dependency.
- The forced oscillation technique (FOT) offers a non-invasive, effort-independent method for assessing pediatric airway function.
- Evaluating bronchodilator response (BDR) using FOT parameters can aid in managing childhood asthma.
Purpose of the Study:
- To evaluate bronchodilator response (BDR) using FOT parameters in asthmatic children aged 2-12 years.
- To assess age- and gender-related differences in airway reversibility measured by FOT.
- To establish reference values for BDR using FOT in a Central Indian pediatric population.
Main Methods:
- A cross-sectional observational study involving 48 asthmatic children (2-12 years) in Central India.
- Measurement of respiratory impedance parameters (R5, R20, R5-20, X5, X20, Ax, Fres) before and after BDR.
- Data analysis using Python and Jamovi, calculating percentage change post-bronchodilator.
Main Results:
- R5-20% change showed improvement, especially in older males (mean 81.83%, median 93.74%).
- Significant reductions were observed in X5 and Ax parameters post-BDR.
- No statistically significant gender differences in FOT parameter changes after adjusting for covariates.
Conclusions:
- R5-20 and Ax are sensitive indicators of airway reversibility in children with asthma.
- FOT parameters can be valuable tools for clinical decision-making in pediatric asthma.
- This study provides data-driven BDR values stratified by age and gender for Central Indian children.
Introduction:
Paediatric asthma diagnosis and monitoring often face challenges due to children's inability to perform effort-dependent tests like spirometry. The forced oscillation technique (FOT) offers a non-invasive, effort-independent alternative for assessing airway function. We set out to evaluate bronchodilator response (BDR) using FOT parameters in asthmatic children aged 2 to 12 years and to assess age- and gender-related differences in airway reversibility.
Material And Methods:
This cross-sectional observational study was conducted at a tertiary care center in Central India. Forty-eight paediatric asthma patients (26 aged 2 to 6 years and 22 aged 7 to 12 years) were recruited. Respiratory impedance parameters (R5, R20, R5-20, X5, X20, Ax, and Fres) were measured before and after BDR. The percentage change post-bronchodilator was calculated using the mean or median based on distribution. Data analysis was performed using Python (with Pandas, NumPy, SciPy, and matplotlib) and Jamovi (v2.3.28).
Results:
R5-20% change demonstrated improvement, particularly in older males (mean: 81.83%, median: 93.74%). X5 and Ax also showed significant reductions. No statistically significant differences were observed between genders for R5, R20, R5-20%, X5%, and X20% change after BDR after adjusting covariate: age, weight, height, and BMI.
Conclusions:
In the absence of central Indian paediatric FOT values for BDR, we adopted an internal, data-driven approach to describe response values stratified by age and gender for central Indian asthmatic children. R5-20 and Ax are sensitive markers of airway reversibility and may serve as valuable tools for clinical decision-making in children.
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